Combining selegeline patch with other psychiatric medications

[Psychresy]

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I've read differing information on this. What are thoughts on using selegeline patch with buproprion and/or stimulants? My understanding was there should not be an issue as it wouldn't not lead to serotonin syndrome nor would it cause hypertensive crisis. Any one able to weigh in?

 

[yoloswagpoop42069]

Selegeline is reportedly more selective for MAOI-B at lower dosages and so more dopaminergic effects in theory.

You should be able to combine them with Wellbutrin or stimulants however it would be prudent to go very slowly in patients who are highly reliable. Aka ideally know the baseline effects of Emsam, Wellbutrin, and stimulants alone. And BP cuff at home to take frequent measurements.

MAOIs: Overview & History – PsychoTropical Research

MAOIs: Overview & History The old irreversible monoamine oxidase inhibitors (MAOIs) like tranylcypromine (Parnate) andphenelzine (Nardil) are extremely effective antidepressant and anti-anxiety drugs that have much less by way of problems, side effects and interactions than most doctors imagine...

www.psychotropical.com

Ken Gillman is the holy grail of MAOI info. It’s where I read a lot and then cross reference to fact check.

 

[yoloswagpoop42069]

17. CNS ‘Stimulants’ and MAOIs – PsychoTropical Research

CNS Stimulants and MAOIS: an updated summary of combining stimulants such as amphetamine , methylphenidate and modafinil with MAOIs.

www.psychotropical.com

Here he talks about stims and MAOIs. Which I am now reading.

 

[yoloswagpoop42069]

In part 2 he talks about amphetamines and releasers and MAOIs.

CNS ‘Stimulants’ and MAOIs Part 2

This commentary outlines how President Trump fits the definition of a severe psychopath, and why most psychiatrists have avoided comment on this obvious point.

www.psychotropical.com

Clearly reuptake inhibiters such as Wellbutrin and Ritalin compounds are safer which makes sense, and releasers like amps less safe. Vyvanse safer than regular amps given its RBC based metabolism.

None without risk in the case of OD.

 

[clozareal]

Selegiline gets metabolized into levomethamphetamine and then levoamphetamine, which is why you sometimes see positive drug tests for meth and amphetamines with those who take selegiline (although much of it is excreted without being metabolized which is even more the case with the patch than oral). There are serious doubts whether these metabolites even do anything.

 

[ObsequiousAplomb]

Selegiline gets metabolized into levomethamphetamine and then levoamphetamine, which is why you sometimes see positive drug tests for meth and amphetamines with those who take selegiline (although much of it is excreted without being metabolized which is even more the case with the patch than oral). There are serious doubts whether these metabolites even do anything.

Interestingly, levomethamphetamine is also a common over-the-counter nasal vapor medication for stuffy nose. Smells nice. Very mild effect on congestion in my experience though.

 

[clozareal]

Interestingly, levomethamphetamine is also a common over-the-counter nasal vapor medication for stuffy nose. Smells nice. Very mild effect on congestion in my experience though.

Any nasal vasoconstrictor would only be temporarily beneficial, about 2-3 days. Even oxymetazoline is recommended to be only used for 3 days. The adrenergic receptors on those blood vessels accommodate quickly!