Posted by Utopia on December 28, 2003, at 16:37:50
In reply to Massive Orgasms!, posted by m0nger on December 28, 2003, at 12:26:13
> haha, sorry about the subject line, it has nothing to do with this post :-D I think maybe the previous post's subject was too generalized (and boring), so nobody read it, and that's why there's been no responses?
>
>
> Anyway, I went through the archives and found some posts to my questions, including the following:
>
> -snip-
>
> "MAOIs and Wellbutrin can be taken together, but only if you are already on an MAOI and adding Wellbutrin very slowly to it. Officially, it's not a recommended combo, but a lot of pdocs have tried it w/ no problem and it is used by many psychopharms.
> However, it is probably not a good idea to add an MAOI, particularly Parnate, to your existing dose of Wellbutrin. There haven't been any studies on the safety of this as far as I know."
>
> http://www.dr-bob.org/babble/20000905/msgs/45093.html
>
> -end snip-
>
> Okay, i am already on Wellbutrin (not too long tho, just a little over a month now). So i would have to stop wellbutrin, then start the Selegiline, then reintroduce the Wellbutrion, if i were to follow that advice?
>
> However, I am not interested in taking the selegiline at unselective high doses, i want to use it in the 5mg-15mg range (the lower the better, that stuff is expensive and i am getting it on my own through the mail so no insurance coverage, doc wouldn't prescribe it, had a knee jerk reaction when i told him it was MAOI, and wouldn't listen to info about it being well tolerated selective B, etc). I am primarily interested in its possible benefit as an aid to smoking abstinence, and to possibly augment anti-depressents i am already taking (Wellbutrin, SAM-e, Zyprexa(?)) along with some of the other possible "prophylactic" benefits (anti-oxident, immune system enhancment, etc). So should I be worried about introducing it into my regiment (see previous post) at a low dose range, since i have been taking Wellbutrin already? I'd really hate to stop the Wellbutrin, as i seem to be getting some benefits from it; depression is reduced, and i am not chain smoking (i tend to chain smoke when severely depressed, as well
>
> Here's some info that was at the selegiline.com site, pertaining to smoking:
>
> -snip-
> "This preliminary study suggests that selegiline (10 mg/day) is safe for use and enhances smoking cessation rates compared with placebo in nicotine-dependent cigarette smokers."
> http://www.selegiline.com/quitsmoke.html
>
> -end snip-
>
> Any replies are welcome, even if ya don't have any answers to my concerns, at least i'll know somebody read the post!
> haha, sorry about the subject line, it has nothing to do with this post :-D I think maybe the previous post's subject was too generalized (and boring), so nobody read it, and that's why there's been no responses?
>
>
> Anyway, I went through the archives and found some posts to my questions, including the following:
>
> -snip-
>
> "MAOIs and Wellbutrin can be taken together, but only if you are already on an MAOI and adding Wellbutrin very slowly to it. Officially, it's not a recommended combo, but a lot of pdocs have tried it w/ no problem and it is used by many psychopharms.
> However, it is probably not a good idea to add an MAOI, particularly Parnate, to your existing dose of Wellbutrin. There haven't been any studies on the safety of this as far as I know."
>
> http://www.dr-bob.org/babble/20000905/msgs/45093.html
>
> -end snip-
>
> Okay, i am already on Wellbutrin (not too long tho, just a little over a month now). So i would have to stop wellbutrin, then start the Selegiline, then reintroduce the Wellbutrion, if i were to follow that advice?
>
> However, I am not interested in taking the selegiline at unselective high doses, i want to use it in the 5mg-15mg range (the lower the better, that stuff is expensive and i am getting it on my own through the mail so no insurance coverage, doc wouldn't prescribe it, had a knee jerk reaction when i told him it was MAOI, and wouldn't listen to info about it being well tolerated selective B, etc). I am primarily interested in its possible benefit as an aid to smoking abstinence, and to possibly augment anti-depressents i am already taking (Wellbutrin, SAM-e, Zyprexa(?)) along with some of the other possible "prophylactic" benefits (anti-oxident, immune system enhancment, etc). So should I be worried about introducing it into my regiment (see previous post) at a low dose range, since i have been taking Wellbutrin already? I'd really hate to stop the Wellbutrin, as i seem to be getting some benefits from it; depression is reduced, and i am not chain smoking (i tend to chain smoke when severely depressed, as well
>
> Here's some info that was at the selegiline.com site, pertaining to smoking:
>
> -snip-
> "This preliminary study suggests that selegiline (10 mg/day) is safe for use and enhances smoking cessation rates compared with placebo in nicotine-dependent cigarette smokers."
> http://www.selegiline.com/quitsmoke.html
>
> -end snip-
>
> Any replies are welcome, even if ya don't have any answers to my concerns, at least i'll know somebody read the post!I think you haven't had many replies because the mis-management of the meds you refer to could cause a massive vascular-cerebral crisis potentially resulting in death.
Remember that Selegiline is a MAO-A AND an MAO-B inhibitor, depending on the dose. This is usually over 40mg per day and that's when the process extends to the gut as well. It does however vary from individual to individual. Welbutrin is known to have Dopamine agonist properties (smoking cessation studies prove it - Zyban)and so does Zyprexa have Dopamine agonist properties(this is why it's a novel anti-psychotic).
So, firstly, if you go onto Selegiline without careful supervision, the resulting rush of dopamine could translate into an unsupervised hypertensive crisis and kill you.
Ex-drug users are seemingly by instinct drawn to Dopamine agonists medicines (or cigarettes because of their dopamine agonist properties)as the original drug of abuse was generally dopamine pushing, including opiates. There's no point in surviving heroin and dying of a blood pressure surge.
Secondly, although there is mention of studies that do not exclude the use of Parnate with Selegiline the risk is stll grave. The Serotonin Syndrome, which results from combining MAOI's and Serotonergic drugs is the evil master here.
It's like taking a normal engine and turbocharging it, then running it at full revs. Eventually that engine will blow because the MAOI's have removed the enzymes that mop up the neurotransmitters that feed the engine, they continue feeding it. It just carries on screaming at full tilt until "boom" - no more engine. Euphoria then death, what a way to go. You'll find that Prozac, for example, and Selegiline are a big no-no due to the risk of the Serotonin Syndrome.
Selegiline is far cleaner (the price is a good indication of it's refinement.
But what about individual response, where one might start having an MAO-A and MAO-B response at lower dosages,for example at 15mg instead of 40mg ? Without realizing the Serotonin Syndrome is a reality in this example as well.Although Welbutrin is a dopamine/adrenalin agonist, serotonin has not been excluded completely. Even Zyprexa could have Serotonergic properties. All these drugs have a smattering of all the neurochecicals with a prevalent one targetting certain sites.
It's the MAOI's that are nasty because they don't get on with the new trendies as they are still first generation.
I think you should find a physician you can work with (no knee jerk reactions!)and plod through a maize which is as potentially dangerous as what you left behind. Then see if you can introduce Selegiline slowly with his assistance.
Trust me, we are impulsives by nature and that question is always there... wouldn't that make me feel better? I've been there so I know (I also believe that a lot of the times instictually we are right) but we haven't had the training to recognize the dangers. Go cautiously.
Lastly, and I quote personally because I cannot remember the study, but St. John's Wort has been know to interfere with treatment during studies and in some cases unusual anxiety has been reported, with very little anti-depressant response being evident.Now... THAT was a long response to your message!!
poster:Utopia
thread:293887
URL: http://www.dr-bob.org/babble/20031225/msgs/294089.html