Posted by Chairman_MAO on June 1, 2004, at 21:33:40
In reply to Re: SSRI and low-dose selegeline-- beneficial, saf » Chairman_MAO, posted by Questionmark on June 1, 2004, at 4:40:28
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> That's neat & interesting (and helpful)-- i would have guessed that an SSRI would help with those things and not with the agitation (and that selegeline would cause those things)... (i think). However, i wonder how much the Remeron might have been a factor in your agitation, too. It's possible you're aware of the differences in agitation quality between Remeron and selegiline though.Well, I shouldn't claim that it DOESN'T help selegiline agitation, because I've never taken it while not taking an SSRI or Effexor. I suspect, however, that it may help with "meta-agitation", i.e. being upset over the fact that it is agitating, but does not cancel out the agitation altogether. Those that have taken Wellbutrin with an SSRI may know what I'm talking about.
I can tell the difference between Remeron agitation and selegiline agitation; moreover, my Remeron dose was 22.5mg, which had no discernable adrenergic effect.
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> > Also note that selegiline can be pro-sexual, but it does not do anything whatsoever to counteract SSRI sexual dysfunction.
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> Wow, thAt's surprising. Freaking SSRI sexual dysfunction-- it's invincible to almost everything.I had excellent results using yohimbine with or without Viagra. Supposedly viagra is contraindicated with yohimbine, but I had no problems. Yohimbine, however, is so anxiogenic that it is used as a probe in investigating panic attacks and recall of emotionally-charged memories. Remeron also worked quite well.
Oooh! I forgot to mention galantamine (Reminyl, Nivalin in Europe), a reversible cholinesterase inhibitor and nicotinic agonist. It has been used in Eastern Europe as a treatment for psychogenic impotence as well as cognitive impairment--even that from GABAnergic drugs such as benzodiazepines! I tried it when I was on Klonopin with celexa AND strattera, and it markedly improved my erections. It may worsen depression however, so proceed with caution. I believe I recommended this to someone on Nardil months ago for cognitive impairment. It could be the magic bullet instead of the dopamine agonists.
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> > At one point I used Celexa + selegiline + Remeron + Neurontin. That was a winner for depression, sexual function, and cognition and helpful for social anxiety, but I still doubt it's what Nardil is.
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> Wow. That's awesome. ... You could very well be right (& probably are) about Nardil being better than that combo. But although Nardil is outstanding for depression and social anxiety (for me and many others), it also has negative effects on my cognition and horrendous effects on my sexual gratification/reward, sexual desire, and ability to orgasm. So i'm actually curious how a drug combination like that Would compare.I also tried Gabitril, and it may have been better than Neurontin. Unfortunately, for all the cognitive impairment it produced at 32mg/day, I may have well been taking Nardil. Perhaps my dose was too high.
The only way you'll know if the combo is good [for you] is to try it. :(
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> Yeah, i've thought for awhile now that Parnate + Klonopin might be an excellent combination (though i didn't fair too well on Parnate alone). i think they would balance each other out in a number of ways and quite nicely as well. You're right though, i should almost definitely "stick with the Nardil and work to resolve the side effects." It truly has helped me beyond words, and may very well have even saved my life. i still hate my life, and so on and so forth, to a significant extent, but i am SO much better off and in SO much less pain than i was. i have so much more hope too. i feel sincerely fortunate and grateful for being able to be on Nardil. (But enough of that).
>Learning to maximally love life, I fear, may take a lifetime--but it's a lifetime well spent. ;) I could say I "hate" my life too, but I at least like posting to psychobabble among many other things, so it's ok, heh.
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> > If amantadine does not work, I suggest moving on to the new dopamine agonists; my first choice would be cabergoline. If you cannot get that, try for pramipexole or ropinirole.
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> i think i will (though i'm pretty sure i'd have to settle for pramipexole or ropinirole) if i am disappointed with the amantadine. But i have read a number of anecdotes from people saying that they tried a dopamine agonist-- or at least one of the two just mentioned-- and it often worked well for about a couple months or so but then not only almost entirely pooped out, but also started causing horrible fatigue after a short time. i don't think i ever recall reading or hearing about someone who was on one of these and experienced even the slightest overall benefit for more than six months. What do you think the likelihood of experiencing poop-out and/or that debilitating fatigue would be, and in how long a time period? Do you think there is any decent way to avoid/prevent, mitigate, or extinguish this side effect and regain its beneficial effects as well? ..Or any DA agonists that do not have this side effect and be likely to continue working? Cuz it hardly seems worth it at all if all you get is 2 weeks of benefit, 3 months of beneficial effects along with terrible fatigue, and then nothing but terrible fatigue-- or something like that.
>I am not aware of the fatigue problem, but I am aware of the problem of my not having clinical experience to acquire such a broad spectrum of anecdotal evidence. All I can say is that the best psychiatrist I've ever had seemed to favor that approach for SSRI-induced sexual dysfunction/cognitive impairment/emotional blunting. And don't forget, if there are people for whom it poops out, there are probably people for whom it works. If I were you, I'd try it out (or galantamine, but DA agonists HELP depression).
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> > By the way, thanks for your compliments; they mean a lot to me. I left this board for a while because I started working and just didn't have the energy to tend to things like this. I have a really hard time tending to multiple spheres of my life; it's a character defect which is worsened by the fact that I receive woefully inadequate psychiatric care.
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> You're welcome. Was just being honest. i'm glad they mean a lot, though. ... That's certainly a good reason (working) to leave this board for awhile. i know what you mean "having a really hard time tending to multiple spheres" of one's life. i have such a difficult freaking time with that too. i probably spend way too much time on this site actually. It's so informative, and often quite helpful, but i think it's just become something of an addiction now. Other areas of my life suffer as a result, to some extent. i want to try to continue reading and posting on this site but to limit myself much more, time wise.I am addicted to this board as well, and have resigned to the addiction. ;) Behaviorists would say I get positive reinforcement here; they would be right.
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> > I hope to "keep it together" mroe this time so that I can stay on this board, move out of my house, make some real money so I can afford a real pdoc; then I could actually make it in school and become a psychopharmacologist. Aaah, to be able to actually help people with my talent [after its sufficiently nurtured by real training] instead of simply posting on this board... ;)
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> That'd be great. i hope you continue posting here. But i hope it doesn't hinder your other goals at all. Good luck with all those other things, by the way. We need psychopharmacologists like you, and you'd be a great one, as far as i can tell.
> But you should have said, "Aaah, to be able to *especially* help people with my talent... even though i do help people some, even a good deal, by posting on this board." i know what you mean though. That would be great.You're right about the rephrasing of my statement. I do not know why I am so self-deprecating; I believe it is a result of living with a lifetime of dysthymia. Hopefully the desipramine which I am trying again out of desparation will help with that. It seems to be working well after only the first does, just like last time. Hopefully this response will continue.
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> Yeah, i would so love to try cabergoline. Man that'd be great.
> i find it kind of interesting and humorous that this professional research study utilized "erotic film and masturbation." i'm sure it's not the only study to do something like that, but i haven't exactly come across it before.I think that congress has prohibited the US government from funding any study into the effects of a drug on human sexuality. I do not remember why this is, but I'm almost positive it's true. Land of the free, home of the asexual (?!?)
> Anyway, thanks so much for your helpful comments, again. And i'm sorry this was so long and tedious to read. i'm horribly tired.
It was a pleasure to read. Be well!
poster:Chairman_MAO
thread:350354
URL: http://www.dr-bob.org/babble/20040527/msgs/352857.html