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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I am on 10 mg (5 mg 2x) of selegiline. Does it wear off? I

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I am on 10 mg (5 mg 2x) of selegiline. Does it wear off? I am waking up feeling not so great but about an hour after my breakfast dose, I am feeling better. Will taking my lunch dose later (say 4:00 as opposed to 1:00) alleviate this problem? It is becoming a little painful (too tired, my body hurts, etc.) to get out of bed ... kind of like when I am in a full swing depression. But then I'm OK after my a.m. dose.
Elliott Sewell, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott Sewell, LPCC, NCC :

Dear friend,

Elliott Sewell, LPCC, NCC :

What is your diagnosis? Is it just depression or might you have bipolar disorder (depression plus mania)?

Elliott Sewell, LPCC, NCC :

Selegeline has a very short half-life (about 90 minutes) and perhaps that is why you are feeling the ups and downs. It is also available in a transdermal patch which would give you a much steadier supply. The brand name for selegeline in a patch is Emsam. Talk to your physician about this.

Elliott Sewell, LPCC, NCC :

Are you taking anything else right now?

Elliott Sewell, LPCC, NCC :

Are you avoiding the foods that must be avoided with selegiline (pickles and similar foods)?

Customer:

I have been diagnosed with bipolar I. Mania kept at bay but big problem with depression. Currently on lithium (900) and lamictal (250). Recently off zyprexa. So it sounds like taking this later in the day will not have much affect on how I feel in the morning if it has such a short half-life.

Customer:

Oh, and I am sterring clear (to he best I can) of foods containing tyramine, so that shouldn't be an issue here.

Elliott Sewell, LPCC, NCC :

Are you more depressive or more manic?

Elliott Sewell, LPCC, NCC :

Does the selegeline increase mania or rapid cycling?

Elliott Sewell, LPCC, NCC :

Sometimes antidepressants can drive the mania or hypomania.

Elliott Sewell, LPCC, NCC :

You are taking lithium and lamictal, however. The lithium works more on the manic side of your behavior and the lamictal on the depressive.

Elliott Sewell, LPCC, NCC :

Have you considered Magnetic Resonance Imaging? It is a proven and widely used (in specialty settings, usually major teaching hospitals or special facilities) that uses magnet induced very mild currents on the brain.

Elliott Sewell, LPCC, NCC :

It is NOTHING like shock therapy (ECT) and does not cause memory loss, pain, or side effects.

Customer:

I am more depressive. Selegeline makes me focused, increases my mood and energy. Prozac made me manic. I have read about Magnetic Resonance Imaging and will serioiusly consider it if this new line of treatment does not work. I'll make an appt. with my dr. to figure out what we can do. My mornings are a bitch. Thanks for your help.

Elliott Sewell, LPCC, NCC :

I have checked drug interactions and the three drugs you currently take do not interfere with each other. I wish you great success, and thank you so much. Warm regards, ***** NCC, CCMHC

Elliott Sewell, LPCC, NCC :

Thank you for your generosity.

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