Selegiline Facts

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Why does selegiline make me feel sleepy? I am taking selegiline 5mg morning and 5mg afternoon, along with 10mg lexapro in the morning. When I take my afternoon dose I usually become very sleepy and I want to go to bed, but at the same time very mentally sharp. Is this normal, why does it happen? I thought it was a stimulant?

Siav replied: "well, it is a stimulant, and it isnt. selegiline is a class of drug called an MAOI, which stands for monoamine oxidase inhibitors. in your brain, there are chemicals that travel between cells as messengers, they are called neurotransmitters. every neurotransmitter does something different (and the same neurotransmitter sometimes does different things on different cells). normally, after a neurotransmitter has signaled a message, your body breaks it down so it doesn't go haywire. MAOIs prevent your body from doing this to a small degree, so that some neurotransmitter can stay around for a little bit longer. one specific neurotransmitter called serotonin is heavily involved in depression, and its levels are increased by selegiline. now serotonin is modified by another chemical in your brain, and becomes melatonin, melatonin is the neurotransmitter that makes your sleepy. the mechanism is very similar to when you eat turkey and get sleepy. when selegiline gets into your body, your body starts breaking it down, one of the broken down products is methamphetamine, which is a stimulant (although in very small amounts). this small dose of methamphetamine contributes to the feeling of being "sharp" that you get."

Is my risk of serotonin syndrome much greater if I take selegiline (l-deprenyl) at the same time as lexapro? ? I have been taking lexapro at night and selegiline when I wake up. I have had no issues at all so far. If I take them both at the same time though, is it very likely to cause a dangerous level of serotonergic activity?

Polski Ogier replied: "What doses are you on? Serotonin syndrome occurs only in extremely high doses. Also, selegiline is an MAO inhibitor, is it not? I would go by what your prescribing physician recommended, but no, I don't think it would cause SS."

I understand there is a generic for Anipryl in dogs called Selegiline.My Vet sells me the Anipryl-didn't know? about the other. Waiting for a call from them today. Anipryl is nearly $100.00 a month. I hope they can find the generic. I called the drugstore they never heard of it (or Anipryl) Thank You.

tlh_98 replied: "Not all pharmacies carry animal drugs, and possibly may not be knowledgeable about them. You'd have to contact your veterinarian to figure out where to get a generic med."

Anybody's dog have seizures on anipryl (selegiline) and SAM-e? My dog had five seizures after he went on anipryl and SAM-e.

raechie5267 replied: "I have not heard of a dog being put on those types of medications due to seizures. Our dachshund was having seizures and we treated it as epilepsy and put her on Phenobarbital. We treated her as it was epilepsy for almost 2 years when she was still having the seizures on a regular basis. We ran a glucose-insulin blood panel and found out her insulin levels were way off the chart. That's when she was diagnosed with Insulinoma. Did your dog have these seizures over a period of time or back-to-back in one day?"

Does Michigan Medicaid cover the EMSAM patch, (selegiline patch)? It's for major depression.? We have a note from her doctor saying that nothing else will work and the only thing that qualifies as a generic causes extreme high blood pressure. If you respond please state how you know. thanks for any help.

Be the Change you Wish to see replied: "In IL, they do not for sure. I work in a pharmacy. They cover all generics, and they make sure you have tried all of them before considering any approval for anythign else. Have you tried all of them? There sure is a lot. Generic zoloft, celexa, prozac, paxil, luvox, wellbutrin, amitriptyline, trazodone. I'm about 50% sure they also cover the brand name Cymbalta and MAYBE Effexor, but I would have to check my list at work. The patches are very very new, and the odds of them covering something as new and expensive as them is unlikely. There are a lot of options in different classes."

Az R replied: "According to the state formulary, Emsam is listed as covered, with no special requirements of qualifications. If they don't, check out for medication assistance programs, BMS, the company that makes Emsam, is rather generous about giving it out to patients who can't afford it."

Why do MAOI antidepressants take so long to start working? Specifically Emsam (Selegiline).? I was prescribed Emsam (Selegiline transdermal patch) for depression ~1 week ago. It is an MAO inhibitor. According to my doc, it could take up to 3 weeks to start working. A study I found online (http://www.ajp.psychiatryonline.org/cgi/content/full/159/11/1869) shows minimal effects over placebo after one week, but it really doesn't start working until 3-4 weeks or even longer. What is the chemical/physiological reason for this delay?

ativan73 replied: "they dont work unless you mke yourself believe they do."

Cafra replied: "I don't remember the exact reason, but the endocrine system in general exhibits this. Hormone production (including neurotransmitters) are produced via sometimes long pathways. Alot of time the transmitter (in this case a monoamine) is already doing it's thing and the medicine is inhibiting a not yet apparent function. So in other words, the action the meds are taking is affecting hormones that have not yet arrived at their point of expression and when they do the affects of the drug should be more noticeable."

Why do some drugs take months of regular use to become effective? I've been taking selegiline for a couple of months and I'm still noticing improvements in its effectiveness and half life even after such a long period of regular use. The same happened with lexapro, it takes many weeks for it to be most effective. Why is this?

Brandon L. M.D., F.A.C.S replied: "Simply put it takes those drugs that long to reach a certain level in your blood."

stacylynn replied: "Some medicines like antidepressants need to build up in your system,they then level off.It is a safe way also to see if you have any negative reactions to the medications."

Simonizer1218 replied: "The fact is that it is not because it takes a long time for drug levels to reach therapeutic levels, but rather has more to do with the mechanism of action of many of these drugs. For many of the drugs, the mechanism of action requires plasticity or changes in proteins to take place. For example, antidepressents usually work by downregulating receptors, and this take several weeks for the proteins to be degraded and made, etc. Note added: it is amazing that I would get a thumbs down for the correct answer. Oh well, it's only Y!A. not the Nobel Prize."

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