Posted by jedi on October 11, 2006, at 1:49:50
In reply to Ensam to $$$ Selegiline cheap, posted by andromeda on October 9, 2006, at 14:31:30
...
So... wondering why not just try generic oral selegiline instead. It is a whole lot cheaper and I don't mind being on the diet. 15 mg of Nardil made me irritable eventually and had to go off of it. Is there much difference between selegiline and nardil?
...Hi,
Selegiline and phenelzine(Nardil) are very different drugs. Phenelzine is a hydrazine derivitive that effects both MAO-A and MAO-B. It also has an effect on GABA. Selegiline at low doses only effects MAO-B. At higher doses it effects both MAO-A and MAO-B. They both effect various neurotransmitters in the brain and other chemicals in the body. By bypassing the gut EMSAM can deliver a higher dose of selegiline to the brain at the same dosage as oral selegiline.IMHO Nardil is still the gold standard for treatment resistant atypical depression. The jury is still out, but I doubt if EMSAM is going to have the horsepower for serious treatment resistant depression.
Take care,
JediCNS Spectr. 2006 May;11(5):363-75.
Transdermal selegiline: the new generation of monoamine oxidase inhibitors.Patkar AA, Pae CU, Masand PS.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27704, USA. [email protected]The clinical use of monoamine oxidase inhibitors (MAOIs) has declined due to concerns about food and drug interactions and waning physician experience. Evidence indicates that MAOIs are effective in depressive disorders, in particular depression with atypical features. Efforts to address safety issues have led to the development of more selective and reversible MAOIs, such as moclobemide. Selegiline, a selective monoamine oxidase B inhibitor, has been approved for the adjunctive treatment of Parkinson's disease at low doses. At higher doses, oral selegiline is also effective in major depressive disorder (MDD) but loses its selectivity and has the potential for tyramine interactions. To overcome these problems, a transdermal formulation of selegiline, the selegiline transdermal system (STS), was developed with novel pharmacokinetic and pharmacodynamic properties. Compared with oral administration, transdermal selegiline leads to sustained plasma concentrations of the parent compound, increasing the amount of drug delivered to the brain and decreasing metabolite production. In addition, STS allows targeted inhibition of central nervous system monoamine A (MAO-A) and monoamine B isoenzymes with minimal effects on MAO-A in the gastrointestinal and hepatic systems, thereby reducing the risk of interactions with tyramine-rich foods (the "cheese-reaction"). Clinical trials have found 6 mg/24 hours of STS to be effective in MDD without the need for dietary restrictions. The efficacy and safety profile of STS supports its use in MDD. It is possible that STS may demonstrate benefit in MDD with atypical features or MDD resistant to other antidepressants. However, more research is needed. Clinicians should familiarize themselves with the properties and indications for the new generation of MAOIs.
PMID: 16641841 [PubMed - indexed for MEDLINE]
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16641841&query_hl=8&itool=pubmed_docsum
poster:jedi
thread:693355
URL: http://www.dr-bob.org/babble/20061003/msgs/693754.html