My own decision. I have bipolar disorder so I can't use TCAs or SSRIs without mania. I have very bad memory loss- not the old man forget my children thing, but the working memory can't have a 5 minute conversation without forgetting what I was talking about and needing to be reminded 2-3 times (average, sometimes I might go double that without once, others, much worse).
I'm depressed, too, which is exacerbating the problem. Since selegiline is noted for it's neuroprotective properties (this discusses it some: http://www.selegiline.com/ -- all statements are well sourced with good studies, but the end gets into some more moronic stuff), so selegiline, at this dose, seems like the best way to alleviate depression without becoming manic. I have sertraline on hand, but now that I have a son, I can't risk that anymore.
What's the difference. Every psychiatrist I've ever seen since I was 16 have let me make every decision. At first it was "here's a list of things intended for this use" now it's "What do you want?" Even when I was in school and needed something to help focus.
I've got a high enough IQ and enough skill with PubMed / PubChem + access to full copies of nearly every paper I've wanted to date that I will have no problem with safety. There wasn't anything published that specifically discussed phenanthrene opioids, except the dextro isomers (d-methorphan most prominently) which either inhibit reuptake of or release serotonin, resulting in serotonin syndrome, which obviously isn't an issue with buprenorphine. The 4-phenylpiperidines and the diphenylheptanones seem to be the only ones in common use with significant effects on serotonin.
Even knowing this, though, I didn't want to risk some adverse interaction. I queried a doctor in my state, but he wasn't immediately available, so I came here.
The only reason I can find for the sort of memory loss I have is a lesion(s) in some place important for short term memory function. Either that or a tumor. I'm on MA until my wife's insurance kicks in four months from now, so I'm doing what I can to get by until I can get into a neurologist. Fortunate, because I can't get in to see a neurologist for 3 months.