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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by christophrejmc on March 12, 2002, at 2:17:54
I recently stopped Nardil (was at 75mg) due to certain side-effects and started 20mg selegiline immediately after. To-day is my fifth day on it.
The main side-effect from selegiline is orthostatic hypotension... well, it mainly happens when I walk up or down stairs; vision fades out and slowly back in, accompanied by dizziness and increased heart rate. These "attacks" usually last for about 5-10 seconds occasionally followed by a slight headache. I've had slight orthostatic hypotension from the other MAOIs and some of the TCAs, but nothing like this. I was wondering whether this side-effect usually goes away after time (or at higher doses) and if it's possibly caused by the residual effects of Nardil interacting with the selegiline.
Also, how long and which dose range does selegiline usually require to take effect? I have been quite depressed since stopping Nardil, and I'd like to know how much time & energy I should give this trial.
Any input would be greatly appreciated.
Cheers,
Christophre
Posted by TSA West on March 12, 2002, at 3:36:46
In reply to Eldepryl (selegiline) startup SEs + more, posted by christophrejmc on March 12, 2002, at 2:17:54
Hello friend,
I would recommend that you try Isocarboxazid, Tranylcypromine, and Moclobemide before Selegiline... but if your heart is set on Selegiline, I would say that 3 weeks at 40 mg of it is an adequate trial. For the orthostatic hypotension increase your salt intake or take sodium tablets.
-------------TSA West ++ -----------------------
Posted by michael on March 12, 2002, at 21:33:53
In reply to Re: Eldepryl (selegiline) startup SEs + more » christophrejmc, posted by TSA West on March 12, 2002, at 3:36:46
Hello,
Can you tell me the there reasons that that you make that recommendation? Any reason to prefer or suggest a particular order that you would suggest (or rank them)?
I ask, because I think maoi's may be in my not so distant future - that is they're next on my list if I have to move on... Thanks for any advice or insights you may have to offer. michael
> Hello friend,
>
> I would recommend that you try Isocarboxazid, Tranylcypromine, and Moclobemide before Selegiline... but if your heart is set on Selegiline, I would say that 3 weeks at 40 mg of it is an adequate trial. For the orthostatic hypotension increase your salt intake or take sodium tablets.
>
> -------------TSA West ++ -----------------------
Posted by TSA West on March 12, 2002, at 23:28:27
In reply to Re: Eldepryl (selegiline) startup SEs + more » TSA West, posted by michael on March 12, 2002, at 21:33:53
I make the recommendation of other MAOIs because currently, there are no published data on the antidepressant efficacy of selegiline outside of Parkinson's Disease (http://www.acnp.org/g4/gn401000103/ch101.html) -- although this is clearly a reasonable avenue of investigation, according to the article.
I'm recommending the use of Isocarboxazid to people now because from what I've heard it has the efficacy of other MAOIs and a tolerability profile similar to the reversible Moclobemide.
This is the end of the thread.
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