![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by Jean Paul on June 10, 2001, at 17:40:32
I´m taking pemoline 37.5 to 56.5 mg/day for increased focus and motivation with good results (I couldn´t tolerate bigger dosages). I began with it just 12 days ago but was thinking if it is possible to augment the dopaminergic effect with selegiline 2.5 to 5 mg/day. Do you think that is it worth? I would appreciate your comments.
Posted by SalArmy4me on June 10, 2001, at 17:45:54
In reply to Selegiline + Pemoline: is it safe?, posted by Jean Paul on June 10, 2001, at 17:40:32
Why not just add Wellbutrin, Bromocriptine, Mirapex, or Requip?
Posted by Jean Paul on June 10, 2001, at 17:57:17
In reply to Re: Selegiline + Pemoline: is it safe? » Jean Paul, posted by SalArmy4me on June 10, 2001, at 17:45:54
> Why not just add Wellbutrin, Bromocriptine, Mirapex, or Requip?
Bupropion isn´t available where I live (Argentina). I find (in theory) Bromocriptine and Mirapex rather similar to selegiline but the latter is more attractive for me due to its antioxidant properties. What is Requip?
Posted by SalArmy4me on June 10, 2001, at 18:46:35
In reply to Selegiline + Pemoline: is it safe?, posted by Jean Paul on June 10, 2001, at 17:40:32
From the Drug Checker at www.drkoop.com:
1. Severe Interaction between pemoline and selegiline
Amphetamines may precipitate severe hypertensive reactions in patients taking MAOIs. MAOIs cause an increase in norepinephrine storage in adrenergic neurons. Amphetamines liberate catecholamines resulting in an exaggerated effect in patients taking MAOIs. Death has been reported. Patients should be counseled to avoid concurrent use of MAOIs and amphetamines (and related drugs).
References:
1. Cuthbert MF, Greenberg MP, Morley SW. Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors. Br Med J. 1969;1:404-6. more info
2. Dally PJ. Fatal reaction associated with tranylcypromine and methylamphetamine. Lancet. 1962;1:1235-6.
3. Elis J, Laurence DR, Mattie H, Prichard BN. Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure. Br Med J. 1967;2:75-8. more info
Posted by Jean Paul on June 10, 2001, at 20:00:18
In reply to Re: Selegiline + Pemoline: is it safe? » Jean Paul, posted by SalArmy4me on June 10, 2001, at 18:46:35
Thanks for your post. I am speculating the following: the interaction may be severe if is true that pemoline acts as the amphetamines on the release of catecholamines, but as far as I know it affects dopamine more exclusively than amphetamines (which adrenergic effects are more active). Pemoline has very low sympathicomimetic action (at least that´s my experience with moderate dosages). But I won´t check this hypothesis with self-experimentation, so I may review other alternatives for boosting dopamine. Any idea? What about bromocriptine: is it a MAO B inhibator too?
> From the Drug Checker at www.drkoop.com:
>
> 1. Severe Interaction between pemoline and selegiline
>
> Amphetamines may precipitate severe hypertensive reactions in patients taking MAOIs. MAOIs cause an increase in norepinephrine storage in adrenergic neurons. Amphetamines liberate catecholamines resulting in an exaggerated effect in patients taking MAOIs. Death has been reported. Patients should be counseled to avoid concurrent use of MAOIs and amphetamines (and related drugs).
>
> References:
> 1. Cuthbert MF, Greenberg MP, Morley SW. Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors. Br Med J. 1969;1:404-6. more info
> 2. Dally PJ. Fatal reaction associated with tranylcypromine and methylamphetamine. Lancet. 1962;1:1235-6.
> 3. Elis J, Laurence DR, Mattie H, Prichard BN. Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure. Br Med J. 1967;2:75-8. more info
Posted by SadSuzie on June 12, 2001, at 21:37:25
In reply to Re: Selegiline + Pemoline: is it safe? » SalArmy4me, posted by Jean Paul on June 10, 2001, at 20:00:18
Working closely with my doctor, I've been taking a combination of low dose Adderall and Selegline for several months. It works wonders - for me.
This combination goes against generally accepted prescribing guidelines. However, it can work well for some people. It is not something to be taken lightly or on your own.
Just wanted to let you know that it is possible. Find a doctor that has worked with the combination before if you decide to try a stimulant and MAOI combo.
Posted by Jean Paul on June 13, 2001, at 13:37:05
In reply to Re: Selegiline + Pemoline: is it safe?, posted by SadSuzie on June 12, 2001, at 21:37:25
Thanks for telling your experience, I found useful to know that the combo is feasible. I would appreciate if you detail the dosages that you have tested of each substance.
Being sincere, the truth is that prescription of stimulants for depression is *impossible* in this country, so self-medication is the rule for people suffering of dopaminergic weakness. So I am the only responsible of my health and consider myself smart enough to find the right path (I am going to do all the research needed). Your advice is wellcome, SadSuzie.> Working closely with my doctor, I've been taking a combination of low dose Adderall and Selegline for several months. It works wonders - for me.
>
> This combination goes against generally accepted prescribing guidelines. However, it can work well for some people. It is not something to be taken lightly or on your own.
>
> Just wanted to let you know that it is possible. Find a doctor that has worked with the combination before if you decide to try a stimulant and MAOI combo.
Posted by AndrewB on June 15, 2001, at 9:27:53
In reply to Re: Selegiline + Pemoline: is it safe? » SadSuzie, posted by Jean Paul on June 13, 2001, at 13:37:05
Jean Paul,
Taking pemoline and low dose selegiline is safe. I’ve been taking selegiline with the amphetamine adderall for over 6 months now. There is the warning against mixing stimulants with MAOIs due to the risk of hypertension. This confuses some doctors because selegiline is defined as an MAOI. In actuality though selegiline is an MAOI only at doses that exceed 15mg/day.For your purposes, increased arousal, you should find 5mg/day sufficient, though some find better effect on 10mg/day or 2.5mg./day. Regardless, keep your dosage to the minimal effective dose. Some people notice the increased arousal (i.e. increased motivation, concentration, vitality, libido) in days but for others it can take a month a half for the effects to kick in.
Also, selegiline, due to its antioxidant activity, is neuroprotective. It especially protects the dopamine neurons. While dopamine neurons are especially vulnerable to damage as we age (compared to other cells in our body), it may be especially important to have such protection when taking a drug like Pemoline, which increases extracellular dopamine concentration and thus may increase the levels of a destructive metabolite of dopamine.
That being said, selegiline is such a powerful antioxidant, namely increasing SOD, that it can throw the bodies antioxidant system out of balance, which is not good in itself. Therefore it is advisable to take N- acetyl cysteine (NAC) also. NAC breaks down into another important antioxidant for the body. Dosage is approx. 1000mg., divided into 3 daily doses. In the US it is sold in healthfood stores.
Some other notes:
1) Pemoline acts on dopamine only, as a reuptake inhibitor or a vesicle (sp?) releasing agent. As such it is not a classic stimulant, so it is said the contradiction between MAOIs and stimulants does not apply OT pemoline. The hypertension risk only belongs to drugs which possess NE activity.
2) MOAIs (i.e. Parnate, high dose selegiline) and stimulants (i.e. amphetamines) can and have been mixed, but careful monitoring of blood pressure should be done during the firstdays of use.
3) Selegiline can cause anxiety in some as a side effect, reduce dosage if this occurs.
4) Pemoline can be hepatoxic, take regular liver tests. Watch for signs of liver dysfunction - yellowing of the eyes, jaundice.
5) Other arousal drugs may work as good or better for you than pemoline. Stimulant trials are fast, so if given the opportunity, one should trial other stimulants to find the one that works the best. Other possibilities are: Dexedrine, Adderall, Adrafinil (this is easy to obtain via mail order if not avial. in Argentina), and Amineptine (Amineptine is no longer in commercial production but supplies of it remain in certain Latin American countries.
6) Pemoline can cause tics and other motor abnormalities. It is my belief that is an indication hyperglutaminergic activity which is neurotoxic. If this occurs, stop the med or take magnesium along with Memantine or Acamprosate. Neither of the latter 2 drugs is probably avail. in your country, besides requiring a prescription and costing from 3 to 8 US dollars/day for an efffective dosage.Best wishes,
AndrewB
Posted by Jean Paul on June 15, 2001, at 12:45:25
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
Your post is useful for me; it is much appreciated. So, hypothesis about hypertension risk not applying due to pemoline irrelevant NE activity seems more feasible now. I will follow your advice on NAC. Here amphetamines are not in pharmacies (just in street); BTW, I have tested this option and consider that their broader and more potent effect is redundant in my case: felt overestimulation and anxiety even in moderate dosages. It doesn´t occure with pemoline, which sellectively boosts appropiate chemichals. I know it isn´t very common to prefer pemoline over amphetamines or ritalin, but it depends on individual cases. Amineptine isn´t available here also. Official repression on potencial stimulants is paranoic, making the paternalistic authorities take awful (and irrational) decisions such as classify piracetam as psychotropic schedule IV or even DMAE -yes!-; not allowing caffeine to be freely sold, nor ma-huang, nor SJW... But everyone can find high-quality cocaine almost everywhere (distorsions are unbelievable).
Despite that, rational decisions still remain as a possibility for people who defend their individuality from "statu quo" abnormalities. Thank you for helping on this issue. I will report results.> Jean Paul,
>
>
> Taking pemoline and low dose selegiline is safe. I’ve been taking selegiline with the amphetamine adderall for over 6 months now. There is the warning against mixing stimulants with MAOIs due to the risk of hypertension. This confuses some doctors because selegiline is defined as an MAOI. In actuality though selegiline is an MAOI only at doses that exceed 15mg/day.
>
> For your purposes, increased arousal, you should find 5mg/day sufficient, though some find better effect on 10mg/day or 2.5mg./day. Regardless, keep your dosage to the minimal effective dose. Some people notice the increased arousal (i.e. increased motivation, concentration, vitality, libido) in days but for others it can take a month a half for the effects to kick in.
>
> Also, selegiline, due to its antioxidant activity, is neuroprotective. It especially protects the dopamine neurons. While dopamine neurons are especially vulnerable to damage as we age (compared to other cells in our body), it may be especially important to have such protection when taking a drug like Pemoline, which increases extracellular dopamine concentration and thus may increase the levels of a destructive metabolite of dopamine.
>
> That being said, selegiline is such a powerful antioxidant, namely increasing SOD, that it can throw the bodies antioxidant system out of balance, which is not good in itself. Therefore it is advisable to take N- acetyl cysteine (NAC) also. NAC breaks down into another important antioxidant for the body. Dosage is approx. 1000mg., divided into 3 daily doses. In the US it is sold in healthfood stores.
>
> Some other notes:
> 1) Pemoline acts on dopamine only, as a reuptake inhibitor or a vesicle (sp?) releasing agent. As such it is not a classic stimulant, so it is said the contradiction between MAOIs and stimulants does not apply OT pemoline. The hypertension risk only belongs to drugs which possess NE activity.
> 2) MOAIs (i.e. Parnate, high dose selegiline) and stimulants (i.e. amphetamines) can and have been mixed, but careful monitoring of blood pressure should be done during the firstdays of use.
> 3) Selegiline can cause anxiety in some as a side effect, reduce dosage if this occurs.
> 4) Pemoline can be hepatoxic, take regular liver tests. Watch for signs of liver dysfunction - yellowing of the eyes, jaundice.
> 5) Other arousal drugs may work as good or better for you than pemoline. Stimulant trials are fast, so if given the opportunity, one should trial other stimulants to find the one that works the best. Other possibilities are: Dexedrine, Adderall, Adrafinil (this is easy to obtain via mail order if not avial. in Argentina), and Amineptine (Amineptine is no longer in commercial production but supplies of it remain in certain Latin American countries.
> 6) Pemoline can cause tics and other motor abnormalities. It is my belief that is an indication hyperglutaminergic activity which is neurotoxic. If this occurs, stop the med or take magnesium along with Memantine or Acamprosate. Neither of the latter 2 drugs is probably avail. in your country, besides requiring a prescription and costing from 3 to 8 US dollars/day for an efffective dosage.
>
> Best wishes,
>
> AndrewB
Posted by Jean Paul on June 15, 2001, at 20:12:29
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
Andrew B,
Reading your post I could notice that pemoline has already produced certain tics, which are irrelevant but persistant, so I decided to check if memantine was avail. here and, fortunately, could find it. I didn´t know anything about it but did some research today: it seems to be a *very* interesting substance. I have read that 30 mg is the standard dose; do you think it is not enough? is it necessary to try smaller doses first?
(If someone else has experience with this substance it would be nice to know about it.)> Jean Paul,
>
>
> Taking pemoline and low dose selegiline is safe. I’ve been taking selegiline with the amphetamine adderall for over 6 months now. There is the warning against mixing stimulants with MAOIs due to the risk of hypertension. This confuses some doctors because selegiline is defined as an MAOI. In actuality though selegiline is an MAOI only at doses that exceed 15mg/day.
>
> For your purposes, increased arousal, you should find 5mg/day sufficient, though some find better effect on 10mg/day or 2.5mg./day. Regardless, keep your dosage to the minimal effective dose. Some people notice the increased arousal (i.e. increased motivation, concentration, vitality, libido) in days but for others it can take a month a half for the effects to kick in.
>
> Also, selegiline, due to its antioxidant activity, is neuroprotective. It especially protects the dopamine neurons. While dopamine neurons are especially vulnerable to damage as we age (compared to other cells in our body), it may be especially important to have such protection when taking a drug like Pemoline, which increases extracellular dopamine concentration and thus may increase the levels of a destructive metabolite of dopamine.
>
> That being said, selegiline is such a powerful antioxidant, namely increasing SOD, that it can throw the bodies antioxidant system out of balance, which is not good in itself. Therefore it is advisable to take N- acetyl cysteine (NAC) also. NAC breaks down into another important antioxidant for the body. Dosage is approx. 1000mg., divided into 3 daily doses. In the US it is sold in healthfood stores.
>
> Some other notes:
> 1) Pemoline acts on dopamine only, as a reuptake inhibitor or a vesicle (sp?) releasing agent. As such it is not a classic stimulant, so it is said the contradiction between MAOIs and stimulants does not apply OT pemoline. The hypertension risk only belongs to drugs which possess NE activity.
> 2) MOAIs (i.e. Parnate, high dose selegiline) and stimulants (i.e. amphetamines) can and have been mixed, but careful monitoring of blood pressure should be done during the firstdays of use.
> 3) Selegiline can cause anxiety in some as a side effect, reduce dosage if this occurs.
> 4) Pemoline can be hepatoxic, take regular liver tests. Watch for signs of liver dysfunction - yellowing of the eyes, jaundice.
> 5) Other arousal drugs may work as good or better for you than pemoline. Stimulant trials are fast, so if given the opportunity, one should trial other stimulants to find the one that works the best. Other possibilities are: Dexedrine, Adderall, Adrafinil (this is easy to obtain via mail order if not avial. in Argentina), and Amineptine (Amineptine is no longer in commercial production but supplies of it remain in certain Latin American countries.
> 6) Pemoline can cause tics and other motor abnormalities. It is my belief that is an indication hyperglutaminergic activity which is neurotoxic. If this occurs, stop the med or take magnesium along with Memantine or Acamprosate. Neither of the latter 2 drugs is probably avail. in your country, besides requiring a prescription and costing from 3 to 8 US dollars/day for an efffective dosage.
>
> Best wishes,
>
> AndrewB
Posted by SHRINK on June 16, 2001, at 4:57:38
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
Dear AndrewB
Hi:-)
At last, someone who seems to know (experientially) about selegiline. I'm one of those so-called 'treatment resistant', atypical depressives. They've tried all the usual classes of anitdepressants (adequate trials at adequate does, blah, blah, blah ...). At the end of all this, I'm still left with what I think is more properly diagnosed as dysthymia. I'd like my old energy and interest in everyday life BACK. I've done quite a bit of research on selegiline in this regard. What's your recommendation? PS The only AD that seemed to have a moderate effect on me was Effexor (at 300mg per day). It also successfully wiped out every other feeling I had too. Does selegiline also turn you into a satisfied zombie - I hope not!
Look forward to your reply ...
Posted by SHRINK on June 16, 2001, at 5:00:52
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
Sorry, forgot to ask you about Pemoline (easy to get here in South Africa). I'd like to know more about its mechanism of action. Is it dopaminergic?
Thanks
Shrink
Posted by shelliR on June 16, 2001, at 19:08:54
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
Hi Andrew. I just started selegiline this week; am up to 10mg. Where did you pick up the info on NAC? Was it part of the patch program?
Shelli
Posted by Vince on June 17, 2001, at 20:11:17
In reply to Re: Selegiline + Pemoline: is it safe?, posted by AndrewB on June 15, 2001, at 9:27:53
> Jean Paul,
>
>
> Taking pemoline and low dose selegiline is safe. I’ve been taking selegiline with the amphetamine adderall for over 6 months now. There is the warning against mixing stimulants with MAOIs due to the risk of hypertension. This confuses some doctors because selegiline is defined as an MAOI. In actuality though selegiline is an MAOI only at doses that exceed 15mg/day.
>
> < snip >...
>
> Best wishes,
>
> AndrewBAndrew, how much Selegiline and how much adderall do you take per day?
A somewhat related question: in a post in April you said that you where taking memantine to prevent tolerance to adderall. Is it still working for you?
I'm interested because dexadrine works for me but only for a few days. I've been waiting since April to ask you the memantine question but I haven't seen you post. Hopefully that's because you're feeling so much better that you don't have time for this kind of thing.
Vince
Posted by Lorraine on June 18, 2001, at 0:43:40
In reply to Selegiline , adderall, memantine questions? » AndrewB, posted by Vince on June 17, 2001, at 20:11:17
Vince, I also take Adderral and Selegiline along with Neurontin. I take 7.5 mg Adderral 2x day; 5 mg of Selegiline 2x day and 300 mg of Neurontin 3x day.
Posted by AndrewB on June 18, 2001, at 3:31:34
In reply to Re: Selegiline , adderall, memantine questions? » Vince, posted by Lorraine on June 18, 2001, at 0:43:40
Hello. I will reply to each poster's question(s) in order.
Jean Paul,
Memantine in Argentina??? I thought it was sold commercially only in Germany. Could you please tell me the price it sells for in Argentina, it would mean so much to me.
I take 30mg. of memantine a day. That actually may be more than you need, given the case study reports I have read. For more info. on indiv. experiences with memantine for tics and the reasonings of why it works go to the US patent database at; http://www.uspto.gov/patft/index.html. Look at patent # 6,057,373.
Take memantine with meals. Start with 5mg., then try 10mg. the next day and 20 the next, given no side effects. Side effects are rare. I experienced the mildest 'spaciness' at first on it.
----------------
Shrink,Selegine will not make you feel like an emotional zombie. When it works, it will help restore energy and vitality and attention. Main side effect for some is anxiety/agitation.
Selegiline in low doses does not treat dysthymia. That is, it will not improve your mood. There is some evidence and good theory behind the idea though that while selegiline and L-phenyalanine by themselves won't improve mood, the combination can be very effective. Dosage of l-phenylalanine (or DL-phenylalanine is 1 th 6 grams a day. Take on an empty stomach 1/2 hour b-4 mealtime, if I remember right. Can cause agitation. It didn't do anything for me.
A combo more likely to work for dysthymia would be amisulpride and selegiline.
Again, recommended dosage of selegiline is 2.5 to 10mg./day. Use lowest effective dose and combine with 1000mg. of NAC/day in three divided doses.
BTW: Pemoline is loosely related to coaine. As I remember, it is a dopamine reuptake inhibtor and/or dopamine releasing agent. Strictly dopaminergic in action.
-----------------
Shelli,Lots of info. out there on the net on selegiline and increased production of the antioxidant SOD. Increased SOD is good in general, except that SOD can create free radicals of its own which can be mopped up efectively by NAC. A good info. source on NAC and antioxidants in general is the DAAIR website: http://www.daair.org/DAAIR/MEMBINFO.NSF
------------
Vince,Memantine, for me at least, is effective for amphetamine tolerance. Whereas before it would poop out ofter about 3 days, leaving me wrung out and irritable, it now gives me a smooth effect (one dosage of 40mg. lasts about 12hours), that I can take every day- giving me energy, concentration, motivation and social confidence.
I've waited to log this post because I was hoping to learn exactly what mechanisms allowed memantine to work this way. But, at this point, at least, I will have to say that it is a bit of a mystery. Presumable, amphetamine induces hyperglutaminergic activity, which incuces the tolerance, which the memantne is able to prevent by limiting glutaminergic activity to within physiologically safe bounds.
Also memantine is seemingly effective for tardive dyskinsia (see patent referred to above). Also effective as a adjunct mood stabilizer to valporate acid (sp?) and possibly lamotrigine.
It is speculated to be effective for OCD disorders. Also I can't help but wonder if it won't prevent , at least in some , instances, of AD poop out.BTW: I take, 5mg/day selegiline, 40mg/day adderall, 30mg./day memantine, 4g.day klonopin at night and 50mg./day of amisulpride.
AndrewB
Posted by Jean Paul on June 18, 2001, at 4:16:33
In reply to Re: Jean Paul, Shrink, Shelli, Vince, posted by AndrewB on June 18, 2001, at 3:31:34
Thanks for the info, AndrewB.
These are memantine´s brand names in Argentina and their prices:* "Neuroplus" (Lab: Baliarda): Memantine 10 mg,
20 pills - US$ 27,50
40 pills - US$ 52,50
* "Akatinol" (Lab: Phoenix): Memantine 10 mg,
30 pills - US$ 49
(Prices were converted considering 1 argentinian peso = 1 american dolar, but better exchange rate may be available for you.)> Hello. I will reply to each poster's question(s) in order.
>
> Jean Paul,
>
> Memantine in Argentina??? I thought it was sold commercially only in Germany. Could you please tell me the price it sells for in Argentina, it would mean so much to me.
>
> I take 30mg. of memantine a day. That actually may be more than you need, given the case study reports I have read. For more info. on indiv. experiences with memantine for tics and the reasonings of why it works go to the US patent database at; http://www.uspto.gov/patft/index.html. Look at patent # 6,057,373.
>
> Take memantine with meals. Start with 5mg., then try 10mg. the next day and 20 the next, given no side effects. Side effects are rare. I experienced the mildest 'spaciness' at first on it.
> ----------------
> Shrink,
>
> Selegine will not make you feel like an emotional zombie. When it works, it will help restore energy and vitality and attention. Main side effect for some is anxiety/agitation.
>
> Selegiline in low doses does not treat dysthymia. That is, it will not improve your mood. There is some evidence and good theory behind the idea though that while selegiline and L-phenyalanine by themselves won't improve mood, the combination can be very effective. Dosage of l-phenylalanine (or DL-phenylalanine is 1 th 6 grams a day. Take on an empty stomach 1/2 hour b-4 mealtime, if I remember right. Can cause agitation. It didn't do anything for me.
>
> A combo more likely to work for dysthymia would be amisulpride and selegiline.
>
> Again, recommended dosage of selegiline is 2.5 to 10mg./day. Use lowest effective dose and combine with 1000mg. of NAC/day in three divided doses.
>
> BTW: Pemoline is loosely related to coaine. As I remember, it is a dopamine reuptake inhibtor and/or dopamine releasing agent. Strictly dopaminergic in action.
> -----------------
> Shelli,
>
> Lots of info. out there on the net on selegiline and increased production of the antioxidant SOD. Increased SOD is good in general, except that SOD can create free radicals of its own which can be mopped up efectively by NAC. A good info. source on NAC and antioxidants in general is the DAAIR website: http://www.daair.org/DAAIR/MEMBINFO.NSF
> ------------
> Vince,
>
> Memantine, for me at least, is effective for amphetamine tolerance. Whereas before it would poop out ofter about 3 days, leaving me wrung out and irritable, it now gives me a smooth effect (one dosage of 40mg. lasts about 12hours), that I can take every day- giving me energy, concentration, motivation and social confidence.
>
> I've waited to log this post because I was hoping to learn exactly what mechanisms allowed memantine to work this way. But, at this point, at least, I will have to say that it is a bit of a mystery. Presumable, amphetamine induces hyperglutaminergic activity, which incuces the tolerance, which the memantne is able to prevent by limiting glutaminergic activity to within physiologically safe bounds.
>
> Also memantine is seemingly effective for tardive dyskinsia (see patent referred to above). Also effective as a adjunct mood stabilizer to valporate acid (sp?) and possibly lamotrigine.
> It is speculated to be effective for OCD disorders. Also I can't help but wonder if it won't prevent , at least in some , instances, of AD poop out.
>
> BTW: I take, 5mg/day selegiline, 40mg/day adderall, 30mg./day memantine, 4g.day klonopin at night and 50mg./day of amisulpride.
>
> AndrewB
Posted by Jean Paul on June 18, 2001, at 4:39:13
In reply to Re: Jean Paul, Shrink, Shelli, Vince, posted by AndrewB on June 18, 2001, at 3:31:34
http://views.vcu.edu/cpdd/98pdf/collins,e.pdf
--------------------------------------------------
THE NMDA ANTAGONIST, MEMANTINE, POTENTIATES SOME SUBJECTIVE EFFECTS OF COCAINE IN HUMANS
E. D. Collins, A. S. Ward, D. M. McDowell, R. W. Foltin, and M. W. Fischman
New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York, NY
Eight male frequent cocaine smokers participated in a 44- to 47- day inpatient and outpatient study to assess the effects of the noncompetitive N-methyl-D-aspartate (NMDA) antagonist, memantine, on cocaine self-administration, subjective effects, and psychomotor performance. Participants were maintained on memantine, 20
mg daily, and placebo, for 7 to 10 days prior to laboratory testing, using a double-blind crossover design. Under each medication condition, participants smoked each of four doses of cocaine base (0, 12, 25, and 50 mg), and were
subsequently given five opportunities, fourteen minutes apart, to self-administer that dose of cocaine or receive a merchandise voucher ($5.00). Each cocaine dose was tested twice under each medication condition, and the order of medication condition and cocaine dose was systematically varied. Vital signs were recorded every two minutes, and subjective effects were assessed at baseline and after each cocaine or voucher delivery. In addition, psychomotor performance was assessed before and after each self-administration session. Memantine maintenance was not associated with changes in psychomotor performance or the number of cocaine doses chosen each session. Memantine maintenance was, however, associated with significant increases in some subjective effects of cocaine: ratings of "good drug effect," "high," "potency," "quality," and street value were all greater under memantine
compared with placebo. These data suggest that NMDA antagonists may have limited usefulness as treatment medications for cocaine abuse.ACKNOWLEDGMENTS: Supported by NIDA grants DA-10755 and DA-00317.
> Hello. I will reply to each poster's question(s) in order.
>
> Jean Paul,
>
> Memantine in Argentina??? I thought it was sold commercially only in Germany. Could you please tell me the price it sells for in Argentina, it would mean so much to me.
>
> I take 30mg. of memantine a day. That actually may be more than you need, given the case study reports I have read. For more info. on indiv. experiences with memantine for tics and the reasonings of why it works go to the US patent database at; http://www.uspto.gov/patft/index.html. Look at patent # 6,057,373.
>
> Take memantine with meals. Start with 5mg., then try 10mg. the next day and 20 the next, given no side effects. Side effects are rare. I experienced the mildest 'spaciness' at first on it.
> ----------------
> Shrink,
>
> Selegine will not make you feel like an emotional zombie. When it works, it will help restore energy and vitality and attention. Main side effect for some is anxiety/agitation.
>
> Selegiline in low doses does not treat dysthymia. That is, it will not improve your mood. There is some evidence and good theory behind the idea though that while selegiline and L-phenyalanine by themselves won't improve mood, the combination can be very effective. Dosage of l-phenylalanine (or DL-phenylalanine is 1 th 6 grams a day. Take on an empty stomach 1/2 hour b-4 mealtime, if I remember right. Can cause agitation. It didn't do anything for me.
>
> A combo more likely to work for dysthymia would be amisulpride and selegiline.
>
> Again, recommended dosage of selegiline is 2.5 to 10mg./day. Use lowest effective dose and combine with 1000mg. of NAC/day in three divided doses.
>
> BTW: Pemoline is loosely related to coaine. As I remember, it is a dopamine reuptake inhibtor and/or dopamine releasing agent. Strictly dopaminergic in action.
> -----------------
> Shelli,
>
> Lots of info. out there on the net on selegiline and increased production of the antioxidant SOD. Increased SOD is good in general, except that SOD can create free radicals of its own which can be mopped up efectively by NAC. A good info. source on NAC and antioxidants in general is the DAAIR website: http://www.daair.org/DAAIR/MEMBINFO.NSF
> ------------
> Vince,
>
> Memantine, for me at least, is effective for amphetamine tolerance. Whereas before it would poop out ofter about 3 days, leaving me wrung out and irritable, it now gives me a smooth effect (one dosage of 40mg. lasts about 12hours), that I can take every day- giving me energy, concentration, motivation and social confidence.
>
> I've waited to log this post because I was hoping to learn exactly what mechanisms allowed memantine to work this way. But, at this point, at least, I will have to say that it is a bit of a mystery. Presumable, amphetamine induces hyperglutaminergic activity, which incuces the tolerance, which the memantne is able to prevent by limiting glutaminergic activity to within physiologically safe bounds.
>
> Also memantine is seemingly effective for tardive dyskinsia (see patent referred to above). Also effective as a adjunct mood stabilizer to valporate acid (sp?) and possibly lamotrigine.
> It is speculated to be effective for OCD disorders. Also I can't help but wonder if it won't prevent , at least in some , instances, of AD poop out.
>
> BTW: I take, 5mg/day selegiline, 40mg/day adderall, 30mg./day memantine, 4g.day klonopin at night and 50mg./day of amisulpride.
>
> AndrewB
Posted by AndrewB on June 18, 2001, at 10:44:11
In reply to Memantine augmentation of dopaminergic drugs?, posted by Jean Paul on June 18, 2001, at 4:39:13
Jean Paul,
Thanks for the price info.
The med. is more expensive in Argentina than Germany - $55 for 50 tablets approx. in Germany. I find it interesting that Argentina in general seems to have some of the highest drug prices in the world. This surprises me since Argentina, though not a poor country, neither is it a rich country. Usually drug companies price drugs roughly in relation to the average wage (excepting countries like Canada where the government negotiates drugs prices as a single bargaining agent, thereby providing leverage in setting prices).
On the cocaine study- I didn't mention it to you but yes, memantine would likely change the quality of your experience with pemoline. For example it is likely to lengthen pemoline's duration of effect, smooth it out, and prevent tolerance over time to its initial effects.
To repeat myself, though I’ve never read that moderate long term use of stimulants causes neurotoxic damage, their mode of action would make it seem possible or likely that damage does occur in small increments over time. One reason why this may not be reported is that the dopamine system ages (after 40) very rapidly in the “normal” healthy person, so it would be easy to ascribe any deterioration to normal aging. If this speculation of neurotoxicity is indeed valid, then the co-commitment use of low dose selegiline, NAC and memantine would seem to be wise. Beyond this, there is good evidence that depression (or certain subtypes) involves hyperglutaminergic (or hypo) activity in parts of the brain and presumably causing resulting damage that could contribute to the typical scenario of depression progressively worsening as we age, if untreated.
A body of knowledge is evolving on the involvement of imbalance between our excitatory and inhibitory receptor systems in various psychiatric disorders; depression, hypophoria, compulsive drug use or pleasure seeking. Along with this knowledge is emerging strategies for restoring balance to these systems. It is likely we will find that some drugs’ ultimate effective actions are different than what we originally presumed. For example, it was thought SSRIs were effective due to their modulation of serotonin. However, it seems (one) of the most central ultimate actions of these meds is their ability (through a chain of events) to upregulate postsynaptic receptor activity on the dopamine D-2, D-3 neurons in the shell of the nucleus accumbens. More topical, is the action of methadone. Apparently it is has stronger activity as a NMDA receptor antagonist (ala memantine) than as opoid receptor ligand. Someone on the board recently said that they have found relief of depression only with methadone and no tolerance or addiction occurred. Perhaps we shouldn’t dismiss their experiences, however atypical, out of hand.
AndrewB
Posted by Vince on June 18, 2001, at 13:46:36
In reply to Re: Memantine + Pemoline - Jean Paul, posted by AndrewB on June 18, 2001, at 10:44:11
AndrewB, can you tell me how you order memantine from Germany? Can you give me the ordering info?
Do you have to get a prescription from your doc? You can email if you would prefer.Vince
> Jean Paul,
>
> Thanks for the price info.
>
> The med. is more expensive in Argentina than Germany - $55 for 50 tablets approx. in Germany. I find it interesting that Argentina in general seems to have some of the highest drug prices in the world. This surprises me since Argentina, though not a poor country, neither is it a rich country. Usually drug companies price drugs roughly in relation to the average wage (excepting countries like Canada where the government negotiates drugs prices as a single bargaining agent, thereby providing leverage in setting prices).
>
> On the cocaine study- I didn't mention it to you but yes, memantine would likely change the quality of your experience with pemoline. For example it is likely to lengthen pemoline's duration of effect, smooth it out, and prevent tolerance over time to its initial effects.
>
> To repeat myself, though I’ve never read that moderate long term use of stimulants causes neurotoxic damage, their mode of action would make it seem possible or likely that damage does occur in small increments over time. One reason why this may not be reported is that the dopamine system ages (after 40) very rapidly in the “normal” healthy person, so it would be easy to ascribe any deterioration to normal aging. If this speculation of neurotoxicity is indeed valid, then the co-commitment use of low dose selegiline, NAC and memantine would seem to be wise. Beyond this, there is good evidence that depression (or certain subtypes) involves hyperglutaminergic (or hypo) activity in parts of the brain and presumably causing resulting damage that could contribute to the typical scenario of depression progressively worsening as we age, if untreated.
>
> A body of knowledge is evolving on the involvement of imbalance between our excitatory and inhibitory receptor systems in various psychiatric disorders; depression, hypophoria, compulsive drug use or pleasure seeking. Along with this knowledge is emerging strategies for restoring balance to these systems. It is likely we will find that some drugs’ ultimate effective actions are different than what we originally presumed. For example, it was thought SSRIs were effective due to their modulation of serotonin. However, it seems (one) of the most central ultimate actions of these meds is their ability (through a chain of events) to upregulate postsynaptic receptor activity on the dopamine D-2, D-3 neurons in the shell of the nucleus accumbens. More topical, is the action of methadone. Apparently it is has stronger activity as a NMDA receptor antagonist (ala memantine) than as opoid receptor ligand. Someone on the board recently said that they have found relief of depression only with methadone and no tolerance or addiction occurred. Perhaps we shouldn’t dismiss their experiences, however atypical, out of hand.
>
> AndrewB
Posted by Neal on June 18, 2001, at 18:03:30
In reply to Re: Jean Paul, Shrink, Shelli, Vince, posted by AndrewB on June 18, 2001, at 3:31:34
>BTW: I take, 5mg/day selegiline, 40mg/day adderall, 30mg./day memantine, 4g.day klonopin at night and 50mg./day of amisulpride.
Andrew: Would so appreciate knowing what your diagnoses is. Dysthymic, depressed, both?
Posted by Jean Paul on June 20, 2001, at 1:37:40
In reply to Re: Memantine + Pemoline - Jean Paul, posted by AndrewB on June 18, 2001, at 10:44:11
Hi, AndrewB:
I am not suprised about argentinian prices of memantine being as high as in Germany: it is easy to explain. Demand curve of this kind of quite "excentric" drugs is very inelastic: any change in price would produce a less-than-proportional change in quantity sold, so the market solution is to establish high prices. However, it is true that this country has some of the highest drug prices. That is in part because argentinian currency is overpriced. Also, because national pharmaceutical industry is very important and control inner market, probably in the bad sense (cartels).
Just 4 days on this combo: selegiline (2,5 mg), pemoline (37,5 mg), memantine (20 mg). I also take a vitamin B complex supplement. Results were extremely curious: quality of pemoline effect changed radically, being more emotionally penetrating (light but persistant EUPHORIA!), and intellectually clean; length of effects was also improved; side effects of pemoline disappeared suddenly, in compensation new side effects: increased heart beat and muscular discomfort, specially (but no anxiety nor psychic over-stimulation); nothig such as mental sensation of being intoxicated or under the effect of a drug. However, if I drink a single coffe, then physical disconfort is intolerable; it is also difficult to sleep at night. I am reaching desired psychic results but have to pay the price of physical nervousness (inner tension), which I assume as stimulation of any dopamine receptor which activation is undesired (side effect due to the quite broad, unsellective action of the combo). Can make any difference amisulpride on that kind of synthoms? Do you take 50 mg, only? Perhaps these are effects of l-amphetamine metabolites of selegiline and I could expect to develope tolerance to them soon. Have you experienced something like that?
> Jean Paul,
>
> Thanks for the price info.
>
> The med. is more expensive in Argentina than Germany - $55 for 50 tablets approx. in Germany. I find it interesting that Argentina in general seems to have some of the highest drug prices in the world. This surprises me since Argentina, though not a poor country, neither is it a rich country. Usually drug companies price drugs roughly in relation to the average wage (excepting countries like Canada where the government negotiates drugs prices as a single bargaining agent, thereby providing leverage in setting prices).
>
> On the cocaine study- I didn't mention it to you but yes, memantine would likely change the quality of your experience with pemoline. For example it is likely to lengthen pemoline's duration of effect, smooth it out, and prevent tolerance over time to its initial effects.
>
> To repeat myself, though I’ve never read that moderate long term use of stimulants causes neurotoxic damage, their mode of action would make it seem possible or likely that damage does occur in small increments over time. One reason why this may not be reported is that the dopamine system ages (after 40) very rapidly in the “normal” healthy person, so it would be easy to ascribe any deterioration to normal aging. If this speculation of neurotoxicity is indeed valid, then the co-commitment use of low dose selegiline, NAC and memantine would seem to be wise. Beyond this, there is good evidence that depression (or certain subtypes) involves hyperglutaminergic (or hypo) activity in parts of the brain and presumably causing resulting damage that could contribute to the typical scenario of depression progressively worsening as we age, if untreated.
>
> A body of knowledge is evolving on the involvement of imbalance between our excitatory and inhibitory receptor systems in various psychiatric disorders; depression, hypophoria, compulsive drug use or pleasure seeking. Along with this knowledge is emerging strategies for restoring balance to these systems. It is likely we will find that some drugs’ ultimate effective actions are different than what we originally presumed. For example, it was thought SSRIs were effective due to their modulation of serotonin. However, it seems (one) of the most central ultimate actions of these meds is their ability (through a chain of events) to upregulate postsynaptic receptor activity on the dopamine D-2, D-3 neurons in the shell of the nucleus accumbens. More topical, is the action of methadone. Apparently it is has stronger activity as a NMDA receptor antagonist (ala memantine) than as opoid receptor ligand. Someone on the board recently said that they have found relief of depression only with methadone and no tolerance or addiction occurred. Perhaps we shouldn’t dismiss their experiences, however atypical, out of hand.
>
> AndrewB
Posted by AndrewB on June 24, 2001, at 17:22:54
In reply to Re: Memantine + Pemoline - Jean Paul » AndrewB, posted by Vince on June 18, 2001, at 13:46:36
Vince,
The best source for memantine is DAAIR, a NY buyers club- prescription required: http://www.daair.org/DAAIR/MEMBINFO.NSF
Posted by AndrewB on June 24, 2001, at 17:31:04
In reply to Re: AndrewB, posted by Neal on June 18, 2001, at 18:03:30
Neal,
My symptomology when unmedicated is:
*social anxiety (of the avoidant personality flavor).
*dysthymia- low mood, self critical thoughts and ruminations, low motivation, low self esteem, etc.
* symptoms induced by exercise that start 24 hours afterwards and continue for 3 days- which include: problems with concentration, memory, energy, staying awake, irritability (moodiness) and even worse mood, social anxiety, motivation and self critical thoughts.AndrewB
Posted by AndrewB on June 24, 2001, at 17:55:44
In reply to Re: AndrewB, posted by Neal on June 18, 2001, at 18:03:30
Jean Paul,
You move quick, I'm surprised you are already on the selegiline and memantine.
A couple of notes, then I'll answer your questions.
First, as a practice, only add on one drug at a time, it is both safer and easier to evaluate the individual effects of each drug added.
Second, you may want to add low dose klonopin (clonazepam) taken 2 hrs before bedtime for a restful sleep.
Third, get your BP checked, to be safe.
Your questions:
*amisulpride will with good probability take away the inner tension of the selegiline. That has been my experience and of some others.
*amisulpride dosage: start at 12.5mg for 6 days, then 25 for 6, then 50 for 6. Some may need 75, some only 12.5 per day (in the morning).
*selegiline’s amphetamine metabolites I believe are insignificant at the low dosage and not responsible for the anxiety. Don't expect the inner tension to go away by itself with time.AndrewB
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.