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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by John on September 9, 1999, at 12:10:53
Hi,
Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
Thanks.
Posted by JohnL on September 9, 1999, at 14:32:00
In reply to High Dose Selegiline (Deprenyl) for Social Phobia?, posted by John on September 9, 1999, at 12:10:53
Hey John. I read in Dr bob's tips comments of other doctors. Some have used high doses of Selegiline for depression. It supposedly has an advantage in terms of side effects because it can actually increase sexual performance rather than hurt it. Also, it metabolizes naturally in the body to amphetamines for a pick-me-up. I get the impression though that it isn't as robust as the real MAOIs. But you know how it is, everything is so different from one person to the next. If you haven't already, try a search in Dr Bob's tips for selegiline. Interesting stuff there.
Posted by Elizabeth on September 15, 1999, at 2:03:03
In reply to High Dose Selegiline (Deprenyl) for Social Phobia?, posted by John on September 9, 1999, at 12:10:53
I didn't find selegiline at all helpful for depression or anxiety, though I did great on phenelzine (until it pooped out...grr). It didn't make me tired; it worsened my insomnia. It also killed what little appetite I had, and I think it might have worsened my anxiety.
One difference between the two drugs is that selegiline won't cause increased levels of GABA in the brain (as phenelzine does) because selegiline isn't related to hydrazine.
Also, the amphetamines that are metabolites of selegiline are l-amphetamine and l-methamphetamine, which aren't the isomers considered to be beneficial to mood and attention; the l- optical isomers are thought to be more responsible for side effects in the periphery. (Dexedrine = d-amphetamine)
I think I remember the study you're talking about on moclobemide. Moclobemide generally seems to have a reputation as a poor antidepressant that will occasionally work for somebody who hasn't responded to other things.
FWIW, Parnate helps somewhat with anxiety (though not as much as Nardil did), doesn't cause weight gain (in general), and (at least for me) doesn't cause sexual dysfunction (caveat: I don't seem to get sexual dysfunction on antidepressants much at all - I was fine on Prozac too, e.g.).
Posted by Rick on September 15, 1999, at 15:16:28
In reply to High Dose Selegiline (Deprenyl) for Social Phobia?, posted by John on September 9, 1999, at 12:10:53
Low-dose Selegiline was adding a nice, activating dimension to the Klonopin I take for Social Phobia. (I also take low-dose, Pindolol Beta Blocker for lowering hypertension/heart-rate, but I don't think it's reputed seratonergenic(sp) effect has any psychotropic effect on me, other than maybe causing a bit more fatigue and perhaps giving me worse dreams).
Oddly, and rather sadly, I had to drop the Selegeline because it was TOO effective in the sexual department. Klonopin already does a lot for me sex-wise, and adding the Selegeline I wentt "over the top"; I couldn't "perform" for more than a very short time without having an explosive orgasm. (Sorry about the explicitness, but this is real mediucine talk here.)
One more thought -- maybe it was the elimination of the Selegeline that got me back into my fammiliar and irritating nutty/nonstop dream mode, NOT the addition of the Beta Blocker.
Rick
----
> Hi,
>
> Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
>
> Thanks.
Posted by Rick on September 15, 1999, at 15:22:43
In reply to Re: High Dose Selegiline (Deprenyl) for Social Phobia?, posted by Rick on September 15, 1999, at 15:16:28
Sorry for the typos in my post reprinted intact immediately below.
DR. BOB -- How about providing a post-correction option? I know another forum that offers this, and it's great!
------
> Low-dose Selegiline was adding a nice, activating dimension to the Klonopin I take for Social Phobia. (I also take low-dose, Pindolol Beta Blocker for lowering hypertension/heart-rate, but I don't think it's reputed seratonergenic(sp) effect has any psychotropic effect on me, other than maybe causing a bit more fatigue and perhaps giving me worse dreams).
>
> Oddly, and rather sadly, I had to drop the Selegeline because it was TOO effective in the sexual department. Klonopin already does a lot for me sex-wise, and adding the Selegeline I wentt "over the top"; I couldn't "perform" for more than a very short time without having an explosive orgasm. (Sorry about the explicitness, but this is real mediucine talk here.)
>
> One more thought -- maybe it was the elimination of the Selegeline that got me back into my fammiliar and irritating nutty/nonstop dream mode, NOT the addition of the Beta Blocker.
>
> Rick
>
> ----
> > Hi,
> >
> > Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
> >
> > Thanks.
Posted by Adam on September 16, 1999, at 22:50:29
In reply to High Dose Selegiline (Deprenyl) for Social Phobia?, posted by John on September 9, 1999, at 12:10:53
I am currently in a research study using a transdermal delivery
method for selegiline. I am becoming more convinced I am on the
drug and not a placebo.I think it has helped with my depression, but, like Elizabeth, it
has left me feeling pretty anxious and I can't sleep very well.
A couple days ago I did something I'm not supposed to do, but since
we're all friends here, I hope I can trust you not to blab :-). I
was essentially spending another night in a row wide-eyed and bolt-
upright in bed at like 2:00 AM, said "what the hell" and popped an
a tablet of lorazepam. In a very short period of time I was on cloud
nine. I felt, as they say, damn good. I never got that response to
lorazepam before, and I think it is a combination of the anti-
depressant effects of selegiline coupled with lorazepam attenuating
selegiline-induced jitters. I slept pretty well, woke up very happy
the next day, and started to feel anxious again about midday. So when
I got home from work I took another. Same deal. I really, REALLY
like this combo.Like I said, this is highly illegal as far as my participation in a
study goes, and I feel sort of bad. Since then I haven't taken
any more lorazepam and am still dealing with anxiety and insomnia. I
feel that these side-effects kind of detract from selegiline's overall
effect. But for the future, I'm quite enthusiastic: selegiline has,
for me, more of a mood-elevating effect than any other antidepressant
I've ever taken (which is the difference, probably, between a little
and none). I might be ecstatic on phenelzine or tranylcypromine, but
I'm not sure I want to be, at this point. I think the anxiety-producing
properties of selegiline may, is some respects, mask any benefit one
might get for social phobia. For me, this pretty much vanished with a
small dose of lorazepam. I'm pretty sure this will be the combination
therapy of my future after the study. I would recommend that anybody
taking selegiline for depression and dealing with the side effects try
this approach. You'll know in about an hour if it works for you or not.
Since lorazepam is great for social phobia, and people are treated
chronically with benzodiazepines all the time (I mean, so what if you're
addicted to it?), and it might actually help one sleep a little, hell, why
not?
> Hi,
>
> Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
>
> Thanks.
Posted by Dr. Bob on September 17, 1999, at 0:19:26
In reply to Re: High Dose Selegiline (Deprenyl) for Social Phobia?, posted by Rick on September 15, 1999, at 15:22:43
> DR. BOB -- How about providing a post-correction option? I know another forum that offers this, and it's great!
What other forum? Do they really let you go back and revise something after it's already been posted, or do they just give you a chance to read over and confirm your message before actually accepting it?
Bob
Posted by Robin on September 26, 1999, at 14:55:00
In reply to High Dose Selegiline (Deprenyl) for Social Phobia?, posted by John on September 9, 1999, at 12:10:53
> Hi,
>
> Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
>
> Thanks.John,
Did you start taking the Selegiline? How is it working for you? I am thinking about giving it a try .What dosage are you taking? Are you taking the generic?
Thanks
Posted by John on September 28, 1999, at 8:55:05
In reply to Re: High Dose Selegiline (Deprenyl) for Social Phobia?, posted by Robin on September 26, 1999, at 14:55:00
Yes,
I've worked my way up to 60 mg/day of Selegiline. I should qualify my response by noting that I remained at that level for only two weeks. Have not noticed any therapeutic effect on social phobia. Cannot indicate the effect upon depression, as I, fortunately, do not suffer from that terrible affliction. Primary benefitof high dose Selegiline, to me, seems to be enhanced libido, but that's it.
Was hoping it would prove as efficacious as Marplan (Isocarboxazid), but as Selegiline is not a hydrazine MAOI, it does not appear to have an effect on GABA. My hypothesis is the effect upon GABA of Phenelzine (whole brain GABA levels have been shown to double)is a primary reason for the difference in efficacy between Phenelzine and the non-hydrazine Parnate (Tranylcypromine) as well as the SSRI's. The SSRI's, I understand may act to indirectly and partially increase GABA through allopregnanolone via the Serotonergic system. This indirect and partical effect, I also hypothesize, may be the reason SSRI's are only partially beneficial in treating social phobia.
Perhaps Marplan, the other hydrazine MAOI now available in the U.S., may offer similar efficacy to Phenelzine, but without the side effects of weight gain and sexual dysfunction.
Johnby the way, I used the trade name formula (Selegiline) as opposed to generic deprenyl. I understand it is very expensive if you don't have good prescription insurance.
> > Hi,
> >
> > Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
> >
> > Thanks.
>
>
>
> John,
> Did you start taking the Selegiline? How is it working for you? I am thinking about giving it a try .What dosage are you taking? Are you taking the generic?
> Thanks
Posted by Rick on September 30, 1999, at 23:42:39
In reply to Re: Yes, I've taken high dose Selegiline 60 mg/day, posted by John on September 28, 1999, at 8:55:05
John, sorry to hear it didn't work out. But based on my own experience with selegeline (but at much lower doses) I had a feeling this would be ineffective for social phobia regardless of dose.BTW, despite the high price, "selegeline" is considered a generic, and I paid only the generic insurance co-pay for it. The primary U.S. brand-name product, as used in Parkinson's, is called "Eldepryl". It's even pricier. I've read life extensionists' claims that pure "l-deprenyl" is better than either of the above (especially the liquid form), but I don't know why, or what the purported difference is. Many websites apparently sell it without prescsription; I doubt that's legal in the U.S.
> Yes, I've worked my way up to 60 mg/day of Selegiline. I should qualify my response by noting that I remained at that level for only two weeks. Have not noticed any therapeutic effect on social phobia. Cannot indicate the effect upon depression, as I, fortunately, do not suffer from that terrible affliction. Primary benefitof high dose Selegiline, to me, seems to be enhanced libido, but that's it.
>
> Was hoping it would prove as efficacious as Marplan (Isocarboxazid), but as Selegiline is not a hydrazine MAOI, it does not appear to have an effect on GABA. My hypothesis is the effect upon GABA of Phenelzine (whole brain GABA levels have been shown to double)is a primary reason for the difference in efficacy between Phenelzine and the non-hydrazine Parnate (Tranylcypromine) as well as the SSRI's. The SSRI's, I understand may act to indirectly and partially increase GABA through allopregnanolone via the Serotonergic system. This indirect and partical effect, I also hypothesize, may be the reason SSRI's are only partially beneficial in treating social phobia.
>
> Perhaps Marplan, the other hydrazine MAOI now available in the U.S., may offer similar efficacy to Phenelzine, but without the side effects of weight gain and sexual dysfunction.
>
>
> John
>
> by the way, I used the trade name formula (Selegiline) as opposed to generic deprenyl. I understand it is very expensive if you don't have good prescription insurance.
> > > Hi,
> > >
> > > Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
> > >
> > > Thanks.
> >
> >
> >
> > John,
> > Did you start taking the Selegiline? How is it working for you? I am thinking about giving it a try .What dosage are you taking? Are you taking the generic?
> > Thanks
Posted by fab on September 20, 2003, at 12:42:09
In reply to Re: Yes, I've taken high dose Selegiline 60 mg/day, posted by Rick on September 30, 1999, at 23:42:39
I used to take ONLY 1.25 mg a day deprenyl (that's right, only 1/4 of a 5mg pill) and it did wonders for social phobia, focus, energy and OCD. I realize this is an old post but wanted to add the experience of a med sensitive who has had terrible results with SSRIs and a great experience with the deprenyl.
In reply to:>
> John, sorry to hear it didn't work out. But based on my own experience with selegeline (but at much lower doses) I had a feeling this would be ineffective for social phobia regardless of dose.
>
> BTW, despite the high price, "selegeline" is considered a generic, and I paid only the generic insurance co-pay for it. The primary U.S. brand-name product, as used in Parkinson's, is called "Eldepryl". It's even pricier. I've read life extensionists' claims that pure "l-deprenyl" is better than either of the above (especially the liquid form), but I don't know why, or what the purported difference is. Many websites apparently sell it without prescsription; I doubt that's legal in the U.S.
>
>
> > Yes, I've worked my way up to 60 mg/day of Selegiline. I should qualify my response by noting that I remained at that level for only two weeks. Have not noticed any therapeutic effect on social phobia. Cannot indicate the effect upon depression, as I, fortunately, do not suffer from that terrible affliction. Primary benefitof high dose Selegiline, to me, seems to be enhanced libido, but that's it.
> >
> > Was hoping it would prove as efficacious as Marplan (Isocarboxazid), but as Selegiline is not a hydrazine MAOI, it does not appear to have an effect on GABA. My hypothesis is the effect upon GABA of Phenelzine (whole brain GABA levels have been shown to double)is a primary reason for the difference in efficacy between Phenelzine and the non-hydrazine Parnate (Tranylcypromine) as well as the SSRI's. The SSRI's, I understand may act to indirectly and partially increase GABA through allopregnanolone via the Serotonergic system. This indirect and partical effect, I also hypothesize, may be the reason SSRI's are only partially beneficial in treating social phobia.
> >
> > Perhaps Marplan, the other hydrazine MAOI now available in the U.S., may offer similar efficacy to Phenelzine, but without the side effects of weight gain and sexual dysfunction.
> >
> >
> > John
> >
> > by the way, I used the trade name formula (Selegiline) as opposed to generic deprenyl. I understand it is very expensive if you don't have good prescription insurance.
> > > > Hi,
> > > >
> > > > Anyone with experience with "high dose," 60 mg/day or greater, Selegiline (Deprenyl) for social phobia? My thinking is that it could be an alternative to Nardil and Parnate if taken as the higher doses where it loses its MAO-B selectivity (>10-15 mg/day). I've seen some threads on what I think is this site (the old RxQx) where practictioners mentioned using up to 60 mg/day of Selegiline in successfully treating depression. So the question: at this level, how does it compare to the "gold standard" Phenelzine? ANYONE WITH EXPERIENCE? By the way, I'd stick with Phenelzine if it didn't leave me with erectile dysfunction (at the slightest dose), anorgasmia (I guess that's secondary to erectile dysfunction - uh, one needs to happen before the other), and gaining 15 lbs. plus. Lastly, I understand that Liebowitz, et al., of the New York State Psychiatric Institute found the reversible MAO inhibitors (RIMA's), namely Moclobemide, to be no better than placebo in their more recent follow-up studies.
> > > >
> > > > Thanks.
> > >
> > >
> > >
> > > John,
> > > Did you start taking the Selegiline? How is it working for you? I am thinking about giving it a try .What dosage are you taking? Are you taking the generic?
> > > Thanks>
This is the end of the thread.
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