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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by andromeda on October 9, 2006, at 14:31:30
Hi,
My pdoc is wanting to start me on ensam next month. I said fine at the time and then I went home and found out how much ensam costs a day. No way I can swing that...not eligible for free/reduced meds and have no pharmacy benefits with my health insurance. 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? I guess I could use ensam patch for a month to see if it helps or not (free samples for awhile anyway).
Any advice would be much appreciated.
Posted by Phillipa on October 9, 2006, at 21:16:14
In reply to Ensam to $$$ Selegiline cheap, posted by andromeda on October 9, 2006, at 14:31:30
I have free patches too. But first I need to wean off my ad and be ad free for two weeks. I like the patch idea if you're having side effects you can take it off. Supposedly it's a mild MAOI. Do you think you'll try the patch you'll know in a month if it will work. Love Phillipa hoping to one day be on the patch.
Posted by willyee on October 9, 2006, at 23:24:15
In reply to Ensam to $$$ Selegiline cheap, posted by andromeda on October 9, 2006, at 14:31:30
> Hi,
> My pdoc is wanting to start me on ensam next month. I said fine at the time and then I went home and found out how much ensam costs a day. No way I can swing that...not eligible for free/reduced meds and have no pharmacy benefits with my health insurance. 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? I guess I could use ensam patch for a month to see if it helps or not (free samples for awhile anyway).
> Any advice would be much appreciated.Ive read on deprenyl a very long time,from books devoting entire chapters to it,to groups having debates on it.
Pre patch,this is the idea of it,the tablets for whatever reason hold a very small response rate.Very small,i personaly know people who due to the cheap price have tons of it because they deem it useless.I have also read this.
The liquid HOWEVER,does hold a very decent record,its even used widly by a group of smart drug users who use certain drugs and nutrients to keep there brain sharp through ageing.
I cant explain why,i know i can attest to the liquid being a very active drug myself.
Again i dont believe ive hear any storeis of a user having success with the tab but one who also used the liquid with it.
The liquid is prob as,or more expensive then the patch,thats what stinks.
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
This is the end of the thread.
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