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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by brynb on August 22, 2012, at 21:26:40
After learning that Lithium can be a neuroprotective, I read up on other psych drugs with this benefit and saw that Selegiline is considered an anti-aging drug and has been used successfully by patients with Parkinson's. Very interesting.
I tried Emsam last year, but found it to be too activating for me (it made me anxious). Does anyone here have positive experiences with Emsam, and if so, at what dose?
Posted by Phillipa on August 22, 2012, at 23:30:39
In reply to Selegiline-good for depression and anti-aging?, posted by brynb on August 22, 2012, at 21:26:40
Robert David in the Archives did should be a long thread there on Emsam & think selegiline should be mentioned. I'd always wanted to try Emsam as a patch and liked the idea of seeing the med. And could remove if bad side effects even though logically knew the med was still in system. Did you like Emsam? Phillipa
Posted by former poster on August 23, 2012, at 1:05:29
In reply to Re: Selegiline-good for depression and anti-aging? » brynb, posted by Phillipa on August 22, 2012, at 23:30:39
I was on Emsam for about 6 months. I don't think it would help with anti-aging because my average hours of sleep were cut in about 1/2 from Emsam. On a good night I would get about 5hrs of sleep. It did relieve my depression. I think Emsam can't be taken alone because of the stimulation and insomnia. I liked the fact that it didn't seem to decrease sexual function or libido.
Posted by SLS on August 23, 2012, at 6:34:44
In reply to Selegiline-good for depression and anti-aging?, posted by brynb on August 22, 2012, at 21:26:40
> After learning that Lithium can be a neuroprotective, I read up on other psych drugs with this benefit and saw that Selegiline is considered an anti-aging drug and has been used successfully by patients with Parkinson's. Very interesting.
>
> I tried Emsam last year, but found it to be too activating for me (it made me anxious). Does anyone here have positive experiences with Emsam, and if so, at what dose?Why do you want to take a drug that is neuroprotective?
I don't think that Emsam will help as many people with depression as most other antidepressants do. People can react to Emsam in a variety of ways. Interestingly, it can very quickly reduce social anxiety; well before an antidepressant effect emerges. It is not surprising that Emsam would produce anxiety in some people. Some of it is metabolized into amphetamines. Have you ever tried amphetamine? If so, how did you react to it? For some people it actually has an anxiolytic effect.
I guess the bottom line is that selegiline has been proven to be neuroprotective in some situations. I don't know if depression is one of them. Perhaps you have seen this addressed in your research. If so, could you please post a few links?
Is there any bipolarity in your case? How long were you on Emsam the first time? Were you taking lithium at the time? If you are committed to taking Emsam, perhaps you can use an anxiolytic drug temporarily to help get you through startup anxiety.
I am currently taking a drug called minocycline. It is a derivative of tetracycline that displays potent neuroprotective, neurogenetic, and anti-inflammatory properties. I also take lithium for neuroprotection and neurogenesis. Clinically, lithium has helped prevent mood "drift" for me. It makes a good adjunct of Parnate for treating depression. Perhaps this would be true of Emsam as well. Minocycline is currently being explored for its potential to act as an antidepressant.
- Scott
Posted by brynb on August 23, 2012, at 6:51:11
In reply to Re: Selegiline-good for depression and anti-aging? » brynb, posted by Phillipa on August 22, 2012, at 23:30:39
Phillipa,
When I tried it, I had just washed out Lexapro and hadn't been on anything else consistently for awhile, so I was pretty messed up and out of whack. I don't think I gave Emsam a long enough chance (maybe 2 weeks or so). I felt too anxious and it didn't help my depression (9mg maybe?).
I'm on a good regimen right now which includes Lithium. I really like the idea that there are some potentially positive effects from these meds.
-b
Posted by brynb on August 23, 2012, at 6:54:35
In reply to Re: Selegiline-good for depression and anti-aging? » Phillipa, posted by former poster on August 23, 2012, at 1:05:29
hi fp,
same here. in the short time i tried it, emsam was too stimulating and didn't help my depression.
-b
Posted by brynb on August 23, 2012, at 7:43:52
In reply to Re: Selegiline-good for depression and anti-aging? » brynb, posted by SLS on August 23, 2012, at 6:34:44
Scott,
I'm basically curious as to which meds produce positive "side effects". (After about 17 years of trying different psych meds, as well as 7 or so years of substance abuse, I worry that I've caused some brain damage, lol.)
Two months ago, I started with a new pdoc who added Lithium to my regimen (Lithium 300mg, Lexapro 20mg and Tramadol 25-50mg). He felt it would be the best option for me (as I've tried many meds, unsuccessfully) to address treatment-resistant depression and mood swings (as well as possible hypomania). It's be a great addition so far. I subsequently read about its neuroprotective potential and was thrilled about the "added" benefit.
I didn't know that Emsam metabolizes into amphetamines. It was too stimulating for me, so it makes sense. I don't do well on amphetamines. I get too anxious and irritable. It did nothing for my depression during the two or so weeks I was on it. I wasn't taking anything else at the time and had previously stopped Lexapro.
I saw your thread about Minocycline. I have an Rx for 100mg from my dermatologist (for breakouts) but rarely take it. Again, great to know there's another potentially good anti-depressant with some benefits.
I have to search for the links about Selegiline. I think you're right; it's possible that it's only a neuroprotective in regard to diseases such as Parkinson's.
As far as my diagnosis and bipolarity, well, it's still unclear. My current pdoc is treating me as MDD w/ GAD, but it's not a definitive diagnosis. I do experience hypomania (usually in the form of irritability) but sometimes from meds (I get speedy). I also experience mania (full-blown) from Neurontin. And, my moods are pretty unstable. Again, I believe the Lithium has been pretty helpful in this area.
-b
Posted by Beckett on August 23, 2012, at 10:10:39
In reply to Selegiline-good for depression and anti-aging?, posted by brynb on August 22, 2012, at 21:26:40
Emsam worked really well for me. It was speedy in the beginning but mellowed with time. It was probably the best AD I have tried to date, and I'd probably be back on it today except that I take a low dose of tramadol for peripheral neuropathy. I think the neuorprtective properties of segilene can come into play (whatever they might be) at doses lower than the patches.
Posted by Hugh on August 23, 2012, at 14:46:34
In reply to Selegiline-good for depression and anti-aging?, posted by brynb on August 22, 2012, at 21:26:40
I took selegiline for a few months in '99, at 5 mg a day, I think. I felt a little less depressed on it, but it was too stimulating for me. But I'm extremely sensitive to stimulants. I decided to try it again a few years ago, and discovered that I was even more sensitive to it than I was in '99.
Dharma Singh Khalsa writes about it in Brain Longevity. He calls it deprenyl, and recommends very low doses of it for neuroprotection -- 1 mg every other day or every third day for people in their thirties, and more the older you get. This site has recommendations on deprenyl as an anti-aging drug. Its author, Ward Dean, claims that liquid selegiline is more potent than selegiline in pill form. I think this claim is very dubious. If you google Ward Dean, you'll find him on quackwatch because he served time for income tax evasion, but he might still be a good doctor for all I know.
http://www.smart-drugs.com/ias-Info/ias-deprenyl.htm
Posted by Phillipa on August 23, 2012, at 19:38:01
In reply to Re: Selegiline-good for depression and anti-aging?, posted by Hugh on August 23, 2012, at 14:46:34
Couldn't 20mg of lexapro and tramadol cause Serotonin Syndrome? Phillipa
Posted by Beckett on August 23, 2012, at 20:53:52
In reply to Re: Selegiline-good for depression and anti-aging? » SLS, posted by brynb on August 23, 2012, at 7:43:52
I think tramadol related serotonin syndrome may be over emphasised. I was on it once with Pristiq and Cymbalta together.. My doctors seemed more concerned about seizures at the time.
Posted by brynb on August 24, 2012, at 1:08:13
In reply to Re: Selegiline-good for depression and anti-aging?, posted by Beckett on August 23, 2012, at 10:10:39
> Emsam worked really well for me. It was speedy in the beginning but mellowed with time. It was probably the best AD I have tried to date, and I'd probably be back on it today except that I take a low dose of tramadol for peripheral neuropathy. I think the neuorprtective properties of segilene can come into play (whatever they might be) at doses lower than the patches.
Beckett-
What dose of Emsam were you taking? And what's your diagnosis (or depression type)?
I started taking Tramadol a few months ago during my last depressive episode when I was experiencing severe leg and arm pain. It helped pull me out of the hole; I responded immediately to its mood enhancing effects.
I started at 100 mg (while on 20mg of Lexapro) and tapered down. Currently, I've been taking 25mg of Tramadol a day, a few days a week (kind of as a prn). I agree that Serotonin Syndrome is probably a rarity w/ Tramadol (at low doses, anyway) and SRIs. I believe Serotonin Syndrome is rare in general, but perhaps I'm wrong.
-b
Posted by SLS on August 24, 2012, at 1:27:49
In reply to Re: Selegiline-good for depression and anti-aging?, posted by brynb on August 24, 2012, at 1:08:13
> > Emsam worked really well for me. It was speedy in the beginning but mellowed with time. It was probably the best AD I have tried to date, and I'd probably be back on it today except that I take a low dose of tramadol for peripheral neuropathy. I think the neuorprtective properties of segilene can come into play (whatever they might be) at doses lower than the patches.
>
> Beckett-
>
> What dose of Emsam were you taking? And what's your diagnosis (or depression type)?
>
> I started taking Tramadol a few months ago during my last depressive episode when I was experiencing severe leg and arm pain. It helped pull me out of the hole; I responded immediately to its mood enhancing effects.
>
> I started at 100 mg (while on 20mg of Lexapro) and tapered down. Currently, I've been taking 25mg of Tramadol a day, a few days a week (kind of as a prn). I agree that Serotonin Syndrome is probably a rarity w/ Tramadol (at low doses, anyway) and SRIs. I believe Serotonin Syndrome is rare in general, but perhaps I'm wrong.Serotonin syndrome is almost guaranteed when a SRI is combined with an MAOI. I really would have liked to have tried tramadol, but I won't go near it because I am currently taking Parnate. I once experimented without my doctor's knowledge and tested a single very small dose (less than 10 mg) of Effexor while taking Parnate. I became delirious and experienced muscle rigidity. My parents were concerned to say the least as they witnessed this happening to me. As I became somewhat lucid, I had the wits about me to have them take my temperature. It was a little high for me, but not anything to be concerned with. Had I taken the full 75 mg dose of Effexor, I might not have been so lucky.
- Scott
Posted by brynb on August 24, 2012, at 1:59:28
In reply to Re: Selegiline-good for depression and anti-aging?, posted by SLS on August 24, 2012, at 1:27:49
>
> Serotonin syndrome is almost guaranteed when a SRI is combined with an MAOI. I really would have liked to have tried tramadol, but I won't go near it because I am currently taking Parnate. I once experimented without my doctor's knowledge and tested a single very small dose (less than 10 mg) of Effexor while taking Parnate. I became delirious and experienced muscle rigidity. My parents were concerned to say the least as they witnessed this happening to me. As I became somewhat lucid, I had the wits about me to have them take my temperature. It was a little high for me, but not anything to be concerned with. Had I taken the full 75 mg dose of Effexor, I might not have been so lucky.
>
>
> - ScottUgh, not fun. Good to know, though. MAOIs are tricky.
Tramadol has been a godsend for me. I generally can't tolerate NRIs, but I'm guessing it's the combo of Tramadol's subtle NRI action, along with it being a mild NMDA antagonist, that has helped me so much. I wonder, is that "telling" of anything as far as my biochemistry goes? Additionally, I do well with "clean" SRIs, hence my Lexapro, so it seems I need to keep my serotonin boosted...
Posted by SLS on August 24, 2012, at 6:05:22
In reply to Re: Selegiline-good for depression and anti-aging? » SLS, posted by brynb on August 24, 2012, at 1:59:28
> >
> > Serotonin syndrome is almost guaranteed when a SRI is combined with an MAOI. I really would have liked to have tried tramadol, but I won't go near it because I am currently taking Parnate. I once experimented without my doctor's knowledge and tested a single very small dose (less than 10 mg) of Effexor while taking Parnate. I became delirious and experienced muscle rigidity. My parents were concerned to say the least as they witnessed this happening to me. As I became somewhat lucid, I had the wits about me to have them take my temperature. It was a little high for me, but not anything to be concerned with. Had I taken the full 75 mg dose of Effexor, I might not have been so lucky.
> >
> >
> > - Scott
>
> Ugh, not fun. Good to know, though. MAOIs are tricky.
>
> Tramadol has been a godsend for me. I generally can't tolerate NRIs, but I'm guessing it's the combo of Tramadol's subtle NRI action, along with it being a mild NMDA antagonist, that has helped me so much. I wonder, is that "telling" of anything as far as my biochemistry goes? Additionally, I do well with "clean" SRIs, hence my Lexapro, so it seems I need to keep my serotonin boosted...
After reading your story and those of others, I am becoming increasingly impressed with tramadol as an antidepressant.Did you respond to any of these drugs?
Effexor
Cymbalta
Savella
AnafranilThanks for the update.
- Scott
Posted by brynb on August 24, 2012, at 8:09:11
In reply to Re: Selegiline-good for depression and anti-aging? » brynb, posted by SLS on August 24, 2012, at 6:05:22
> After reading your story and those of others, I am becoming increasingly impressed with tramadol as an antidepressant.
>
> Did you respond to any of these drugs?
>
> Effexor
> Cymbalta
> Savella
> Anafranil
>
> Thanks for the update.
>
>
> - Scott
Hi Scott,I couldn't tolerate Cymbalta or Effexor. Both meds made me physically ill and completely off, even at the lowest doses. I never tried Savella or Anafranil.
Tramadol has been effective for me at very small doses. I started at just 100 mg (50mg twice daily) during my last depressive episode, and this dose helped get me out of bed. I've been able to taper down easily since then (I'm sure the addition of Lithium has helped, too) and actually feel better from smaller doses of Tramadol (25mg or 50mg once a day).
The mood boosting effect is pretty immediate (within an hour or so) and it's not at all euphoric or synthetic feeling (I don't in any way get high from it). Plus, I haven't had any side effects.
That said, it's infuriating that so many psych docs discount and dismiss this drug. It doesn't make sense. Perhaps it has something to do with the stigma of opioids/opiates, and Tramadol is technically considered an opioid/analgsic (though it's a very mild one, at best).
-b
Posted by Beckett on August 24, 2012, at 11:13:07
In reply to Re: Selegiline-good for depression and anti-aging?, posted by brynb on August 24, 2012, at 1:08:13
> > Emsam worked really well for me. It was speedy in the beginning but mellowed with time. It was probably the best AD I have tried to date, and I'd probably be back on it today except that I take a low dose of tramadol for peripheral neuropathy. I think the neuorprtective properties of segilene can come into play (whatever they might be) at doses lower than the patches.
>
> Beckett-
>
> What dose of Emsam were you taking? And what's your diagnosis (or depression type)?
>
> I started taking Tramadol a few months ago during my last depressive episode when I was experiencing severe leg and arm pain. It helped pull me out of the hole; I responded immediately to its mood enhancing effects.
>
> I started at 100 mg (while on 20mg of Lexapro) and tapered down. Currently, I've been taking 25mg of Tramadol a day, a few days a week (kind of as a prn). I agree that Serotonin Syndrome is probably a rarity w/ Tramadol (at low doses, anyway) and SRIs. I believe Serotonin Syndrome is rare in general, but perhaps I'm wrong.
>
> -bHi B,
My pdoc adhered strictly to the two week washout from emsam to tramadol. No one I spoke to would mix an MAOI with tramadol. I don't know what type of depression I have. It involves a slowing down--lots of physical symptoms, so I guess I responded well to the stimulation emsam provided which seems gentler somehow to me than say Effexor.
Tramadol as a psyciatric med seems understudied or somehow neglected. It might be helpful to a few people with somatic symptoms as an add-on. Or in other instances?
Posted by Bob on August 25, 2012, at 17:10:29
In reply to Re: Selegiline-good for depression and anti-aging? » brynb, posted by SLS on August 23, 2012, at 6:34:44
>
> I am currently taking a drug called minocycline. It is a derivative of tetracycline that displays potent neuroprotective, neurogenetic, and anti-inflammatory properties. I also take lithium for neuroprotection and neurogenesis. Clinically, lithium has helped prevent mood "drift" for me. It makes a good adjunct of Parnate for treating depression. Perhaps this would be true of Emsam as well. Minocycline is currently being explored for its potential to act as an antidepressant.
>
>
> - Scott
>
>Scott, do you have any link references on studies or articles about Minocycline and depression? Seems interesting.
Bob
Posted by SLS on August 25, 2012, at 20:52:05
In reply to Re: Selegiline-good for depression and anti-aging? » SLS, posted by Bob on August 25, 2012, at 17:10:29
> > I am currently taking a drug called minocycline. It is a derivative of tetracycline that displays potent neuroprotective, neurogenetic, and anti-inflammatory properties. I also take lithium for neuroprotection and neurogenesis. Clinically, lithium has helped prevent mood "drift" for me. It makes a good adjunct of Parnate for treating depression. Perhaps this would be true of Emsam as well. Minocycline is currently being explored for its potential to act as an antidepressant.
> Scott, do you have any link references on studies or articles about Minocycline and depression? Seems interesting.http://www.ncbi.nlm.nih.gov/pubmed?term=minocycline%20depressive
There are several ongoing trials testing minocycline for bipolar depression.
http://clinicaltrials.gov/ct2/show/NCT01514422
- Scott
Posted by brynb on August 26, 2012, at 11:10:04
In reply to Re: Selegiline-good for depression and anti-aging?, posted by Beckett on August 24, 2012, at 11:13:07
> Hi B,
>
> My pdoc adhered strictly to the two week washout from emsam to tramadol. No one I spoke to would mix an MAOI with tramadol. I don't know what type of depression I have. It involves a slowing down--lots of physical symptoms, so I guess I responded well to the stimulation emsam provided which seems gentler somehow to me than say Effexor.
>
> Tramadol as a psyciatric med seems understudied or somehow neglected. It might be helpful to a few people with somatic symptoms as an add-on. Or in other instances?Hi Beckett,
Thanks for your response. I think Tramadol has a slightly stimulating effect for me, which is also more gentle than traditional NRIs.
I think it's very unfortunate that many pdocs are so rigid in their approach to depression, and often don't or won't think out of the box in terms of meds.
I started taking Tramadol for somatic pain in my arms and legs and was surprised when I started to feel better mentally, too.
Recently, my pdoc wanted me to go off Tramadol to see how I do without it (he also doesn't want me to be "dependent" on it). In an effort to be compliant and respectful of his experiment, I did, and for the past 2 weeks have only taken it as a prn. The last few days I found myself slipping again, becoming depressed and irritable and sleeping round the clock. (My family was pretty quick to point this change out, too.) When I get like this, I often lose the insight and self-awareness I usually have, but realized this morning it's in the absence of Tramadol. I'm ready and armed with this info for my pdoc when I see him next week! Apparently, it was more effective than I realized, and as much as I'd love to be on the most minimum amount of meds as possible, I'm afraid that's not an option right now...
-bryn
Posted by Bob on August 26, 2012, at 13:05:12
In reply to Re: Selegiline-good for depression and anti-aging? » Bob, posted by SLS on August 25, 2012, at 20:52:05
> > > I am currently taking a drug called minocycline. It is a derivative of tetracycline that displays potent neuroprotective, neurogenetic, and anti-inflammatory properties. I also take lithium for neuroprotection and neurogenesis. Clinically, lithium has helped prevent mood "drift" for me. It makes a good adjunct of Parnate for treating depression. Perhaps this would be true of Emsam as well. Minocycline is currently being explored for its potential to act as an antidepressant.
>
> > Scott, do you have any link references on studies or articles about Minocycline and depression? Seems interesting.
>
> http://www.ncbi.nlm.nih.gov/pubmed?term=minocycline%20depressive
>
> There are several ongoing trials testing minocycline for bipolar depression.
>
> http://clinicaltrials.gov/ct2/show/NCT01514422
>
>
> - ScottThanks!
This is the end of the thread.
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