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Hilary, Murray, Judith and list, Selegiline is a selective MAO inhibitor, in lower doses it only inhibits MAO B (or- is it A -I never remember) In higher oral doses doses it is an antidepressant over 30 mg/day (and perhaps at lower doses that PWP take may have some antidepressant effect also). At lower doses it (supposedly) does not interact with other drugs and foods but because everybody reacts differently many of the warnings of drug interactions at higher doses are given to people taking 5-10 mg / day even if they are unlikely. There are several kinds of interactions possible and the SSRI antidepressants like Prozac and Zoloft can be used but with caution. I wonder whether the patch with its more constant blood level allows the delivery of a dose that is more effective without inhibiting the MAO A (or is it B?) and increasing the possibility of food and drug interaction. Or- more cynically this may be a way to market the drug differently without being too obvious. (like Zyban is marketed for smoking control and has a different price structure than Wellbutrin- the exact same drug (bupropion). And Sharon- I am so glad Seroquel has lived up to its expectations at least for your mother. It was released since I left practice and in spite of their initial promise there have been several other drugs that I had hoped would replace Clozaril but none came close for PD patients. Also- a personal note- I have backed off a little from the list over the past week or so. My dystonia is acting up and I can't sit at the computer for the amount of time I could previously. I am still going to work on the FAQ regarding how to deal with volume. Also there may have ben some questions directed at me that I did not answer. I apologize for that. Charlie Hilary Blue wrote: > > I don't understand. First of all, how can there be a whole article about > eldepryl without mentioning PD.? And secondly, how come in all the years that > I took eldepryl, there was never a mention made of its being an antidepressant > - and I took prozac as well - and I'm still alive to tell the tale, even > though its now considered a no-no to combine those two? And I've been totally > off antidpressants for nigh on two years now - with no indication of > depression. > Does this mean that eldepryl as absorbed through the skin is an antidpressant, > but needs to be taken orally to be effective against PD? I'm confused. > > Hilary Blue (50,33,24) > > ????????????????????????????????????????????????????????????????????????????????? > > judith richards wrote: > > > > January 07, 1999 > > > > Slap-happy medicine > > A new patch promises to deliver an antidepressant that doctors are > > claiming works better than Prozac > > > > Luiza Chwialkowska--National Post > > > > Canadians already spend hundreds of millions of dollars on nicotine > > patches to help them quit smoking, nitroglycerine patches to ease > > angina, and estrogen patches to restore hormones lost in menopause. But > > as the millennium unfolds, they may be able to slap on an even more > > pleasing remedy: the happy patch. > > > > A Florida-based pharmaceutical company is developing the first > > "transdermal delivery system," or patch, that will deliver > > antidepressant medication directly into the bloodstream. > > > > "It really is wild. It's the Second Coming. It's out of this world," > > says Alexander Bodkin, a Harvard psychiatrist who is leading the > > clinical trials of the patch. Not only will the patch deliver the drug > > in a quick and easy way, says Bodkin, but the new delivery method will > > resurrect a long-ignored depression medication, Eldepryl, that for some > > people has stronger effects than such popular medications as Prozac or > > Zoloft. > > > > "The Prozac experience for many people is relief. Anxiety lightens, > > fretfulness subsides, negative emotions become attenuated and quiet and > > go down to the normal range. Which is wonderful," explains Bodkin. " But > > the brain systems which mediate reward, engagement > > . . . are not affected by Prozac." > > > > Patients who used the patch drug, however, felt "energized, activated, > > and stimulated," he says. > > > > Eldepryl, or selegiline, is a so-called monamine oxidase inhibitor > > (MAOI), a class of drugs considered highly effective for fighting > > depression. Some MAOIs are available in Canada. But Eldepryl has only > > recently become available here for patients suffering from > > Parkinson's disease. > > > > The unique property of Eldepryl, according to Bodkin, is that not only > > does it raise seratonin levels in the brain the way Prozac does, it also > > raises levels of dopamine. Higher dopamine levels may account for what > > Bodkin calls the "striking cheer-giving effects" of the drug. > > > > Some patients "couldn't even remember how it felt to be depressed," he > > says. > > > > Eldepryl has been known to have antidepressant effects since 1967, but > > the pill was associated with dangerous side effects such as high blood > > pressure and stroke. The side effects disappear, Bodkin says, when the > > drug is administered through a patch. Taken orally, Eldepryl could > > interfere with the body's ability to process certain foods. However, > > skin delivery allows the chemical to bypass the digestive system. > > > > "The pills melt in your stomach, so anything lining your gut gets > > poisoned . . . If you take it to the skin, you basically go straight to > > the brain and only a little bit goes to the liver and the gut lining," > > says Bodkin. > > > > Unlike other antidepressants, which can cause headaches and sexual > > dysfunction in some people, Bodkin says the new patch has "essentially > > no side effects." > > > > The only downside? Skin irritation. It can be quite itchy," he says. > > > > There's also the patch itself. "It's a little more conspicuous than > > Prozac because you can see patches and some people might be > > uncomfortable with that," Bodkin concedes. "On the other hand, there are > > some people who forget to take their pills," he says. > > > > He says that patients consume only half of the antidepressant medication > > they are prescribed. "People forget, people deny, people wish they > > didn't have the problems they have," he says. The patch could help > > people who are too distraught to follow their medication schedule. > > > > Bodkin tested the idea with the co-operation of six medical centres > > across the United States, including McLean Hospital, a > > Harvard-affiliated psychiatric facility in Belmont, Mass., where he > > works, at two sites in Philadelphia, and one each in Kansas, Florida, > > and Washington State. > > > > Eighty-nine patients used a skin patch containing selegiline, and 88 > > patients used a placebo patch with no medication. The initial tests > > showed that the patch system had "impressive" antidepressant properties. > > > > Somerset Pharmaceuticals, Inc., the company leading the trials, cautions > > that it is still "exploring" how safe and effective the drug is. But > > Bodkin is busy turning away eager patients who want to join his new, > > larger study now under way. "We're swamped," he says. > > The appeal of the patch could be enormous. The antidepressant market is > > worth more than $300-million in Canada alone. > > > > Bodkin says the patch could be the next Prozac, the next > > psycho-pharmaceutical success story. And if the patch system works, its > > benefits may not be limited to Eldepryl, he says. "You could do all > > kinds of things with this delivery system." > > > > Last year, Canadians spent more than $28-million on nicotine patches and > > gums, according to research firm ACNielsen. Nitroglycerine patch sales > > topped $36-million last year, and > > estrogen patches are worth more than $29-million a year, according to > > IMS Health, a medical information company. > > > > Could caffeine patches be next? "Why not?" Bodkin says. But he adds a > > word of caution about a possible patch proliferation. "People might > > start getting a little lumpy." > > -- > > Judith Richards, London, Ontario, Canada > > <[log in to unmask]> > > ^^^ > > \ / > > \ | / Today’s Research > > \\ | // ...Tomorrow’s Cure > > \ | / > > \|/ > > ``````` -- ****************************************************************************************** Charles T. Meyer, M.D. Middleton (Madison), Wisconsin [log in to unmask] ******************************************************************************************