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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Emme on December 27, 2003, at 22:47:33
Does anyone have any understanding of whether I should wash out selegiline before trying 5HTP? Because selegiline is a selective MAO-B inhibitor at the dosage I'm using (10 mg), I am thinking it might not be necessary. But...there may be something I'm not thinking of. Thanks.
Emme
Posted by sb417 on December 28, 2003, at 0:47:27
In reply to Wash out selegiline before 5HTP?, posted by Emme on December 27, 2003, at 22:47:33
PLEASE wash out before taking anything like that. Although I haven't taken Selegiline yet, I asked my doctor about it because at one point I was thinking about taking it. I asked him about taking other meds as long as I keep the dose below 10 mg. He said that even if you keep the dose below 10 mg, ALL of the MAOI restrictions still apply except for the food restrictions. All medication interaction precautions must be followed, regardless of the dose.
Posted by Emme on December 28, 2003, at 23:19:45
In reply to Re: Wash out selegiline before 5HTP? » Emme, posted by sb417 on December 28, 2003, at 0:47:27
> PLEASE wash out before taking anything like that. Although I haven't taken Selegiline yet, I asked my doctor about it because at one point I was thinking about taking it. I asked him about taking other meds as long as I keep the dose below 10 mg. He said that even if you keep the dose below 10 mg, ALL of the MAOI restrictions still apply except for the food restrictions. All medication interaction precautions must be followed, regardless of the dose.
Okay. Thanks. I'll plan on a couple of weeks washout if I want to try out 5HTP.
Posted by btnd on January 2, 2004, at 19:07:42
In reply to Wash out selegiline before 5HTP?, posted by Emme on December 27, 2003, at 22:47:33
No need to. Check out this article:
"In 1978 Mendelwicz and Youdim treated 14 depressed patients with 5 mg deprenyl plus 300 mg 5-HTP 3 times daily for 32 days. (1) Deprenyl potentiated the antidepressant effect of 5-HTP in 10/14 patients. 5-HTP enhances brain serotonin metabolism, which is frequently a problem in depression (37), while deprenyl enhances dopamine/noradrenalin activity. Under-activity of brain dopamine, noradrenalin and serotonin neural systems are the most frequently cited biochemical causes of depression (18,19,37), so deprenyl plus 5-HTP would seem a natural antidepressant combination. "
Posted by sb417 on January 2, 2004, at 20:32:11
In reply to Re: Wash out selegiline before 5HTP? » sb417, posted by Emme on December 28, 2003, at 23:19:45
Emme, are you taking selegiline under a doctor's supervision? If you plan to combine anything with it, please check with your doctor first, even if there are some reports in the literature of combinations without a washout period. I have never taken selegiline, but I did take another MAOI a long time ago. I was able to successfully combine it with a stimulant, which is usually contraindicated; however, I did it under medical supervision and it had to be timed in a particular way.
Posted by Emme on January 3, 2004, at 0:01:14
In reply to Re: Wash out selegiline before 5HTP? » Emme, posted by btnd on January 2, 2004, at 19:07:42
Can you post the reference for the article? I'd like to get a copy to give to my pdoc.
Thanks,
Emme> No need to. Check out this article:
>
> "In 1978 Mendelwicz and Youdim treated 14 depressed patients with 5 mg deprenyl plus 300 mg 5-HTP 3 times daily for 32 days. (1) Deprenyl potentiated the antidepressant effect of 5-HTP in 10/14 patients. 5-HTP enhances brain serotonin metabolism, which is frequently a problem in depression (37), while deprenyl enhances dopamine/noradrenalin activity. Under-activity of brain dopamine, noradrenalin and serotonin neural systems are the most frequently cited biochemical causes of depression (18,19,37), so deprenyl plus 5-HTP would seem a natural antidepressant combination. "
Posted by Emme on January 3, 2004, at 1:00:12
In reply to Re: Wash out selegiline before 5HTP? » Emme, posted by sb417 on January 2, 2004, at 20:32:11
> Emme, are you taking selegiline under a doctor's supervision?
But of course - I need the script after all! :)
> If you plan to combine anything with it, please check with your doctor first, even if there are some reports in the literature of combinations without a washout period.
You needn't worry. I'm not irresponsible. I *always* *always* tell my pdoc of any changes I want to make and discuss anything I want to try, even if I'm also getting input from the board.
Truth is, I don't think any of her other patients has tried 5HTP (let alone selegiline + 5HTP). We talked briefly about it as an option and she was open to it, but I hadn't decided for sure whether I wanted to try it. She's a good, cautious pharmacologist. If she's got any doubts then I trust that she'll make phone calls and do the research before I try 5HTP.
The abstract the other poster talked about was pretty much what I thought might be the case as far as interaction. But you're right that it's better to plan to be conservative when in poorly charted territory. So I'm into day 5 of washout.
Posted by sb417 on January 3, 2004, at 13:05:06
In reply to Re: Wash out selegiline before 5HTP? » sb417, posted by Emme on January 3, 2004, at 1:00:12
Hi Emme,
It sounds as if you have a good doctor. I agree that it's best to be conservative and careful with these medications, especially with the med combinations. By the way, on another post you said that your circadian rhythms are topsy-turvy. Perhaps your medication washout is exacerbating that? Would it be possible to do the med washout more slowly so that you experience fewer withdrawal effects? Before the washout, did selegiline cause your body clock to be turned upside down? By the way, early morning bright lights and vigorous exercise early in the day seem to help my body clock, but I have to do the early lights and early exercise consistently. If I try them for just a day or so, they don't usually help with the phase shift. Also, late night television and late night computer use (especially Internet surfing) wreak havoc on my circadian rhythms. Part of that is from the mental stimulation, but the lights from the TV and/or computer also affect the eyes, the pineal gland and melatonin. It helps, as night time approaches, to try to gradually "wind down," use dimmer lights, don't drink caffeinated tea or coffee, eat more carbohydrates and less protein in the evening, etc.
Posted by Emme on January 3, 2004, at 18:11:02
In reply to Re: Wash out selegiline before 5HTP? » Emme, posted by sb417 on January 3, 2004, at 13:05:06
Hi.
> It sounds as if you have a good doctor.
Yes. She's very conscientious and attentive and sharp. I feel very lucky to have gotten referred to her.
> By the way, on another post you said that your circadian rhythms are topsy-turvy.
That's one way of putting it. :( It's total chaos. I'm exhausted and jittery and anxious and just slept most of today after being wired and wacked out this morning after being up till 4 last night. Mood getting worse because nothing is getting done.
> Perhaps your medication washout is exacerbating that? Would it be possible to do the med washout more slowly so that you experience fewer withdrawal effects?
Well, I was using selegiline at a low dose and somewhat sporadically. So I couldn't really taper more slowly than what I was doing to begin with.
> Before the washout, did selegiline cause your body clock to be turned upside down?
Hmmm...no..I don't think so. Actually, it all started with some really stressful things happening and then getting a flu shot on Christmas eve. It's been chaos since then.
> By the way, early morning bright lights and vigorous exercise early in the day seem to help my body clock, but I have to do the early lights and early exercise consistently. If I try them for just a day or so, they don't usually help with the phase shift.
The exercise thing is a problem right now. I'm not sure what to do. Normally I can't exercise in the morning. I'm little and have no reserves and I seem to need at least a few hours of food and water before I can try to work out. I exercise at night (usually several nights a week) and it actually helps me wind down - a reasonable workout is calming. But I'm so unbelievably exhaustd at the moment, my arms and legs feel really weak. I'm trying to get in a walk every day, but it's not helping me work back into it. This seems to be phase shift plus feeling extra cruddy. Myabe I've caught some sort of bug... I don't know what to think. How old can one be and still get mono..?
> Also, late night television and late night computer use (especially Internet surfing) wreak havoc on my circadian rhythms. Part of that is from the mental stimulation, but the lights from the TV and/or computer also affect the eyes, the pineal gland and melatonin.
Yeah, I can see how web surfing would keep one from winding down. I should make sure I don't go too late. Watching old videos, however, actually lulls me to sleep pretty well. It seems to pull my mind from my worries. That or a good book - no matter how engrossing the book, it helps me fall asleep. I definitely need something to concretely separate the day from the night and stop my brain from obsessing.
> It helps, as night time approaches, to try to gradually "wind down," use dimmer lights, don't drink caffeinated tea or coffee, eat more carbohydrates and less protein in the evening, etc.
Yeah, that's right...now that you mention it, when I'm hungry in the evening, I usually want carbs. Caffeine's a non-issue -can't tolerate much of it anyway. I think I'm going to try the warm milk route tonight.
Thanks for writing.
Emme
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