Posted by Adam on August 2, 1999, at 19:18:56
In reply to Re: Study and Adam, posted by Robin on July 31, 1999, at 9:22:40
Wellbutrin is a bit mysterious in that it's mechanism of action
isn't well understood. It is thought to be an inhibitor of
dopamine reuptake, but its active metabolites also inhibit the
reuptake of serotonin and norepinepherine, albeit weakly. It
tends to be fairly activating, from what I hear. I tried it, and
found that it did essentially nothing at all to me one way or
the other.Selegiline is a very different beast. It is a potent and
irreversible inhibitor of monoamine oxidase B when taken at doses
around 5mg/day. At higher doses, it also is able to inhibit
monoamine oxidase A. MAO-B is primarily responsible for the
breakdown of dopamine in the brain, where MAO-A is primarily
responsible for the breakdown of serotonin and norepinepherine.
Selegiline also mildly inhibits the reuptake of dopamine, and
some of its metabolites are amphetamines, again affecting the
dopamine system.MAO-A is also involved in the breakdown of tyramine in the gut.
At low doses of oral selegiline, there's no need to follow
dietary restrictions, but at higher doses, one needs to avoid
foods rich in tyramine to prevent the "cheese effect", just like
with other irreversible inhibitors of MAO-A. The study I am
involved with now is using a transdermal delivery system (a patch,
like the nicotine patch) to get around the hazards of MAOI use
and hypertensive crises caused by the tyramine pressor effect.
Bypassing the gut allows one to take high doses of selegiline
without having to watch what you eat. At least, that's how it
looks. I've read in one paper that transdermal delivery of
selegiline changes its metabolite profile somewhat, with less
l-amphetamine being produced.The doctors I spoke with at McLean hope the patch delivery system
will be available on the market in a couple of years, or maybe
even less. I don't know if selegiline will work for me yet, but
if it does work for some people, it seems like it would be a
wonderful thing to reap the benefits of a MAOI without having to
deal with some of the hazards.
> > > Hey, Elizabeth,
> > >
> > > Yep, I'm in the Boston area. How are things going
> > > with you in the study?
> >
> > I'm not in the study, but I know Dr. Bodkin (actually I talked to him about it when he was working on the grant proposal - he seemed excited about it) so I'm interested to know how it goes.
> >
> > I tried oral selegiline (40mg, if I remember correctly) and it caused me nothing but grief (reminded me of Wellbutrin). Oh well. For a lot of people it doesn't have any side effects to speak of. (I sort of feel like I shouldn't tell you what they were for me, so as not to bias you. :->)
> >
> > Email me if you want (it's shapere@aol.com). I'd be interested to meet "in real life," if you would.
>
> Adam, What was the comparison of Wellbutrin and Selegiline? I hated Wellbutrin it made me more depressed. I haven't tried Selegiline, but was considering it.
> Robin
poster:Adam
thread:5905
URL: http://www.dr-bob.org/babble/19991001/msgs/9511.html