Psycho-Babble Medication Thread 87632

Shown: posts 1 to 21 of 21. This is the beginning of the thread.

 

Status of the Selegiline Patch?

Posted by spike4848 on December 21, 2001, at 20:19:23

Anyone know if this Patch is ever coming out?

 

Re: Status of the Selegiline Patch?

Posted by OldSchool on December 21, 2001, at 21:05:19

In reply to Status of the Selegiline Patch?, posted by spike4848 on December 21, 2001, at 20:19:23

> Anyone know if this Patch is ever coming out?

Id very much like to know the answer to this question as well. Also Id like to know if the MAOI diet will apply to the MAOI patch.

Old School

 

Re: Status of the Selegiline Patch?

Posted by IsoM on December 22, 2001, at 2:34:25

In reply to Status of the Selegiline Patch?, posted by spike4848 on December 21, 2001, at 20:19:23

All I could find is that EMSAM™ (selegiline transdermal system [patch], 20 mg/20 cm2)
is still pending FDA approval. How long before
the FDA decides?

> Anyone know if this Patch is ever coming out?

 

Re: Status of the Selegiline Patch?

Posted by OldSchool on December 22, 2001, at 10:26:35

In reply to Re: Status of the Selegiline Patch?, posted by IsoM on December 22, 2001, at 2:34:25

> All I could find is that EMSAM™ (selegiline transdermal system [patch], 20 mg/20 cm2)
> is still pending FDA approval. How long before
> the FDA decides?
>
> > Anyone know if this Patch is ever coming out?

Id like to know real real bad.


Old School

 

Write to the FDA?

Posted by spike4848 on December 22, 2001, at 12:05:01

In reply to Re: Status of the Selegiline Patch?, posted by OldSchool on December 22, 2001, at 10:26:35

It seems the patch has helped so many people ... often when no other treatment works. In other diseases like HIV and cancer, medication gets fast track approval by FDA. Well, depression is a life threatening disease also. Maybe we all should collectively write FDA to speed up the patch's approval process!

All in favor, say "I."

Spike

 

Re: Write to the FDA?

Posted by OldSchool on December 22, 2001, at 12:55:40

In reply to Write to the FDA?, posted by spike4848 on December 22, 2001, at 12:05:01

> It seems the patch has helped so many people ... often when no other treatment works. In other diseases like HIV and cancer, medication gets fast track approval by FDA. Well, depression is a life threatening disease also. Maybe we all should collectively write FDA to speed up the patch's approval process!
>
> All in favor, say "I."

Well the thing about this MAOI patch is Ive read the FDA lifted the requirement for the MAOI diet in later stage trials. I read that Dr. Bodkin said when the Selegiline goes right into the bloodstream bypassing the gut, this eliminates the need for the MAOI diet. If this is true, that would be fantastic for some of us who would very badly like to try an old style MAOI for refractory depression. But cannot deal with the MAOI diet, nor the potential for a hypertensive crisis.

So to me, from the things Ive read, the Selegiline MAOI patch seems like you can have your cake and eat it too. You get the MAOI antidepressant effect which is second to none, but you dont have to go on the MAOI diet and need not worry about blood pressure problems.

Of course, if it turns out you still must adhere to the MAOI diet on the patch, I dont even see the point in going thru all the trouble of developing the MAOI patch. To me, thats the whole advantage of it.

here is an article about the MAOI patch, in which its mentioned the FDA lifted the MAOI diet restrictions on later stage trials.

http://www.news.harvard.edu/gazette/1998/12.10/depression.html

I could use an MAOI right NOW, however I cant hang with this pain in the ass MAOI diet, nor can I risk blood pressure/stroke problems. Frankly I could use this MAOI patch NOW, not a year or two from now.

Tell the FDA to hurry up, there are many many refractory depressives who would like to try MAOIs but dont want to take the pill form because the MAOI diet is incompatible with a good lifestyle (I like to eat).


Old School

 

Re: maoi diet hypertension

Posted by michael on December 24, 2001, at 22:19:41

In reply to Re: Write to the FDA?, posted by OldSchool on December 22, 2001, at 12:55:40

...So to me, from the things Ive read, the Selegiline MAOI patch seems like you can have your cake and eat it too. You get the MAOI antidepressant effect which is second to none, but you dont have to go on the MAOI diet and need not worry about blood pressure problems.
>

From what I undersand, the maoi diet isn't necessary (with the transdermal patch), but you do still have to worry (or be cautious) regarding blood pressure/hypertensive episodes - specifically, with respect to taking other medications in conjunction with maoi's. michael

 

Re: selegiline patch - responses some people's ?s

Posted by Elizabeth on December 28, 2001, at 14:18:48

In reply to Re: Status of the Selegiline Patch?, posted by OldSchool on December 21, 2001, at 21:05:19

Food interactions are not a concern with parenterally administered MAOIs (because the MAOI avoids passing through the GI tract), but there are still risks from drug-drug interactions (with SSRIs, decongestants, certain opioids (Demerol, Ultram), etc.).

The FDA frequently drags its feet approving new drugs. I'm still wondering if sublingual buprenorphine is ever going to be available in the U.S.

Until the patch is approved (if it ever is!), you always have the option of taking high doses of oral selegiline (you must observe dietary restrictions if you're going to do this, but as I've often said, the MAOI diet isn't really that big a deal -- I've posted the list of restricted foods here several times, and you could probably find it by searching the PB archives). Selegiline is often tolerated by people who have trouble with other MAOIs; it seems to cause fewer problems with weight gain, cardiovascular effects (hypertension and orthostatic hypotension), etc. than other MAOIs often do. Personally, I found it jittery, but then again, I was already having some pretty problems with untreated anxiety at the time.

-elizabeth

 

Re: selegiline patch - responses some people's ?s

Posted by spike4848 on December 28, 2001, at 22:03:39

In reply to Re: selegiline patch - responses some people's ?s, posted by Elizabeth on December 28, 2001, at 14:18:48

Please correct me if I am wrong .... I though I had read some posts in the past where people responded to the patch but found oral selegiline not as effective? Or do I have it backwards, that most people who respond to the patch do equally as well on oral medications?

Spike4848

 

Re: selegiline patch vs. oral (Cam?) » spike4848

Posted by Elizabeth on December 29, 2001, at 6:27:19

In reply to Re: selegiline patch - responses some people's ?s, posted by spike4848 on December 28, 2001, at 22:03:39

> Please correct me if I am wrong .... I though I had read some posts in the past where people responded to the patch but found oral selegiline not as effective? Or do I have it backwards, that most people who respond to the patch do equally as well on oral medications?

Maybe Cam can come up with an explanation. Here're my thoughts, though, FWIW:

I think that people who find oral selegiline less effective might not be taking a high enough dose. I can't see why else there would be a problem. Sometimes drugs are absorbed very poorly orally compared to parenterally, and as a result the oral dose must be much higher than the parenteral one (morphine is a good example -- thirty years ago or so, it was thought that morphine wasn't orally active at all).

-elizabeth

 

Re: selegiline patch vs. oral (Cam?) » Elizabeth

Posted by Cam W. on December 29, 2001, at 13:55:37

In reply to Re: selegiline patch vs. oral (Cam?) » spike4848, posted by Elizabeth on December 29, 2001, at 6:27:19

Elizabeth - I have not had much clinical experience with selegiline (Elderyl™), but I can posit a theory why the transdermal patch may be more effective. Aside from being concentrated in the liver, cytochrome enzymes are also found in the intestine. Now, I am not sure if Elderyl is metabolized via the cytochrome system, but if it is, then it could be that the phenomenon of "first pass" effect may be taking place.

As the Elderyl is being absorbed into the body, cytochrome enzymes could be metabolizing some of the molecule into it's metabolites, and further metabolism could be taking place in the liver, as general circulatory blood vessels from the the intestine pass through the liver before being distributed to the rest of the body. It is also known that Elderyl has an extremely short half-life.

By using a controlled (slow-release) transdermal patch, I would think that the selegiline avoids a majority of the first pass effect, hence more of the molecule will be active at more sites throughout the body (including the brain).

Also, the slower release of selegiline into by a transdermal patch would be like taking smaller doses over a longer period of time, thus you would expect better (ie. higher) blood levels of the parent drug, for longer periods, thus more efficacy.

As I say, I am guessing at this, but hey, it sounds like a fairly plausible explanation, and is probably what is going on.

As an aside, the only really interesting fact I do remember about selegiline is that 2 of its 3 major metabolites are amphetamine and methamphetamine. I wonder how much these contribute to its use in the psychiatric field. (This may have been mentioned; I have not been following any of the selegiline posts).

- Cam

 

Re: selegiline patch vs. oral » Cam W.

Posted by Elizabeth on December 30, 2001, at 17:07:20

In reply to Re: selegiline patch vs. oral (Cam?) » Elizabeth, posted by Cam W. on December 29, 2001, at 13:55:37

Cam --

If it were just a matter of first-pass metabolism, wouldn't you expect that a high enough dose of oral selegiline (Eldepryl) would work as well as the patch?

> As an aside, the only really interesting fact I do remember about selegiline is that 2 of its 3 major metabolites are amphetamine and methamphetamine. I wonder how much these contribute to its use in the psychiatric field.

Two of the metabolites of selegiline (which is itself an l- isomer) are l-amphetamine and l-methamphetamine, which I'm given to understand have more peripheral and less central activity than the d- isomers.

-elizabeth

 

Thanks for the info; gotta be slow release, then (nm) » Elizabeth

Posted by Cam W. on December 30, 2001, at 18:44:42

In reply to Re: selegiline patch vs. oral » Cam W., posted by Elizabeth on December 30, 2001, at 17:07:20

 

Selegiline Patch? FDA throws spanner in works. » OldSchool

Posted by JahL on March 31, 2002, at 11:52:19

In reply to Re: Status of the Selegiline Patch?, posted by OldSchool on December 22, 2001, at 10:26:35

FDA have deemed EMSAM to be 'NOT APPROVABLE'. Tossers.

http://biz.yahoo.com/rf/020327/n27633392_1.html

J.


+++++++++++++++++++++++++++++++++++

> > All I could find is that EMSAM™ (selegiline transdermal system [patch], 20 mg/20 cm2)
> > is still pending FDA approval. How long before
> > the FDA decides?
> >
> > > Anyone know if this Patch is ever coming out?
>
> Id like to know real real bad.
>
>
> Old School

 

Re: Selegiline Patch? FDA throws spanner in works.

Posted by michael on March 31, 2002, at 14:41:50

In reply to Selegiline Patch? FDA throws spanner in works. » OldSchool, posted by JahL on March 31, 2002, at 11:52:19

> FDA have deemed EMSAM to be 'NOT APPROVABLE'. Tossers.
>
> http://biz.yahoo.com/rf/020327/n27633392_1.html
>
> J.
>
>
> +++++++++++++++++++++++++++++++++++

'Watson said the agency determined that the patch, called Emsam, isn't approvable unless the companies came up with more data showing it works. Somerset has scheduled a meeting with FDA officials. '

Ironic, given some of the "testimonials" seen here...

I know that some of us have experience working with the FDA, or knowledge regarding how the FDA works (or doesn't work - unenthusiastic ha ha)... Does anyone have a feel for EMSAM's future prospects? Delay, vs. Doom?

Just looking for an informed opinion and/or educated guess... Thanks
michael

 

Re: Selegiline Patch? FDA throws spanner in works.

Posted by OldSchool on March 31, 2002, at 20:02:16

In reply to Selegiline Patch? FDA throws spanner in works. » OldSchool, posted by JahL on March 31, 2002, at 11:52:19

> FDA have deemed EMSAM to be 'NOT APPROVABLE'. Tossers.
>
> http://biz.yahoo.com/rf/020327/n27633392_1.html
>
> J.
>
>

Yeah, I found out the other day it got turned down by the FDA. Typical, its what I expected. I wouldnt expect this MAOI patch to EVER get FDA approved. I doubt we will ever see it...ever. Its too good of a thing. MAOIs cause remission rates at too high of a rate compared to SSRIs. An MAOI patch that was actually safe and eliminated the need for the MAOI diet would probably dent the SSRI market pretty heavily, as well as the Effexor market.

I say bullshit to it all man...we live in a world of shit.

Old School

 

Re: Selegiline Patch? FDA throws spanner in works.

Posted by RJM on February 1, 2003, at 7:17:10

In reply to Re: Selegiline Patch? FDA throws spanner in works., posted by OldSchool on March 31, 2002, at 20:02:16

I have been experimenting with low dosage Selegiline under the tounge in combo with Lexapro.
(Weaned myself off Wellbutrin because the up & down got to be too much, plus its expensive)

Deprenyl Seems to help with motivation & attention & mood.

Seems to aggrivate insomnia and cause some wild dreams.

Some excess sweating too.

 

Re: Deprenyl and lexapro.

Posted by borderguy on February 2, 2003, at 13:37:50

In reply to Re: Selegiline Patch? FDA throws spanner in works., posted by RJM on February 1, 2003, at 7:17:10

> I have been experimenting with low dosage Selegiline under the tounge in combo with Lexapro.
> (Weaned myself off Wellbutrin because the up & down got to be too much, plus its expensive)
>
> Deprenyl Seems to help with motivation & attention & mood.
>
> Seems to aggrivate insomnia and cause some wild dreams.
>
> Some excess sweating too.

Hi, I was interested in your post. I have taken deprenyl for some time with improvement in energy and mood but just not getting there in terms of decision making and clarity of thought. I tried to combine 5htp with the cocktail without much success.

Later, I've tried Lexapro and and a small does of ritalin, but, while the clarity of thought is fine, I am extremely on edge (which isn't a life affirming effect either).

I know there a lots of data out there warning of the dangers of combining an SSRI and an MAO and it certainly is not recommended as a main stream therapy. However, I have read a short study indicated that low doses of celexa and deprenyl combined did not cause an immediate untoward side effects in parkinson patients.

So I was interested in what dose of Lexapro and Deprenyl you were taking? Also are you augmenting the deprenyl with Phenalynine?

Thanks!

 

Re: Deprenyl and Zoloft

Posted by Jacob on February 2, 2003, at 17:16:32

In reply to Re: Deprenyl and lexapro., posted by borderguy on February 2, 2003, at 13:37:50

I'm interested in experimenting similarly. I've been on zoloft for 2 years. I bought a bottle of the liquid (Jumex) and the one time I tried it, the sweating was disturbing, I don't recall the feeling very well, but might try again.


> I have been experimenting with low dosage Selegiline under the tounge in combo with Lexapro.
> > (Weaned myself off Wellbutrin because the up & down got to be too much, plus its expensive)
> >
> > Deprenyl Seems to help with motivation & attention & mood.
> >
> > Seems to aggrivate insomnia and cause some wild dreams.
> >
> > Some excess sweating too.
>
> Hi, I was interested in your post. I have taken deprenyl for some time with improvement in energy and mood but just not getting there in terms of decision making and clarity of thought. I tried to combine 5htp with the cocktail without much success.
>
> Later, I've tried Lexapro and and a small does of ritalin, but, while the clarity of thought is fine, I am extremely on edge (which isn't a life affirming effect either).
>
> I know there a lots of data out there warning of the dangers of combining an SSRI and an MAO and it certainly is not recommended as a main stream therapy. However, I have read a short study indicated that low doses of celexa and deprenyl combined did not cause an immediate untoward side effects in parkinson patients.
>
> So I was interested in what dose of Lexapro and Deprenyl you were taking? Also are you augmenting the deprenyl with Phenalynine?
>
> Thanks!
>
>

 

Re: Deprenyl

Posted by borderguy on November 23, 2003, at 17:45:25

In reply to Re: Deprenyl and lexapro., posted by borderguy on February 2, 2003, at 13:37:50

Does anyone have any experience using low dose deprenyl as a monotherapy for depression or in conjuction with other compounds (like phenalyaline)?
Thanks,

 

Re: Deprenyl

Posted by maxx44 on November 24, 2003, at 22:44:16

In reply to Re: Deprenyl , posted by borderguy on November 23, 2003, at 17:45:25

i'm tampa bay area. somerset phrarmaceutical is in tampa, and apparently suplying patches. seems on the market, and living decades more probably means high price. oral deprenyl sellers are online. cheap, except for the fact that you need a lot to break treatment-resistent depression. it really looks like the 1st proven 'fountain of youth'---but probably 240,000,000 americans can't afford it. this may involve interesting matters of law and jurispudence. to me this is no different from national smallpox vaccine, or flu shots. at present prices, with several children my cost would be thousands/month. if deprenyl proves out, denial to all americans would be grossly negligent and criminal. like smoking.


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