# A month into Selegiline



## Diya (Aug 28, 2008)

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## Edwin (Jun 19, 2008)

I have to agree the mindset of pdocs in the Netherlands is kind of conservative. My pdoc refused to prescribe Prozac with my Wellbutrin, because he's afraid I might get seizures and doesn't think dopamine can be functionally differentiated from norepinephrine.


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## euphoria (Jan 21, 2009)

Freesix88 said:


> This is a quote from doc "It's jsut your personality, you can't do really anything about it. " lololol


Yes, this is what doctors/psychiatrists told me for my schizoid personality disorder, and is completely untrue. The fact is they don't consider changing personalities to be their job, only to correct anxiety disorders, depression, etc.

You'll probably have to take it into your own hands unless you have co-occurring disorders like ADD which are treated with dopaminergic drugs that make you more outgoing. Here in the UK we don't even have Wellbutrin for depression. SSRI + mirtazapine is one of the best combinations I could get legally.


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## jim_morrison (Aug 17, 2008)

What was the major goal of being put on selegeline? was it primarily to treat social anxiety, or a secondary disorder?


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## robotaffliction (Jul 24, 2009)

Diya said:


> ADD and SAD basically. It worked so well for both during the first couple of weeks, but it stopped working for SAD after the initial euphoria wore off. It gives me energy at 5mg and higher and I can concentrate better on things.
> 
> I tried an SSRI called Zoloft for 7 months before @ 150 mg. In most cases, SSRIs either cause inorgasmia or libido loss, but that was never the case with me. If anything, SSRI improved the quality of orgasms.
> 
> On the other hand, a dopaminergic MAOI like selegiline that is supposed to have a positive sexual impact completely destroyed my libido. I guess my brain is just weird like that.


well, selegiline tablets are only used off-label for depression and/or ADD, mainly because they don't work very consistently for a lot of people. MAO-B inhibition is great for treating parkinson's disease, but with the tablets you mainly just hit MAO-B (no A) and get a lot of weak amphetamine metabolites (L-amphetamines that are less effective than the normal D-amphetamines).

i'm not sure selegiline is really supposed to have a prosexual effect, definitely the dopamine reuptake inhibitors generally do (because when the dopamine gets fired, it acts longer), but increasing dopamine pretty much everywhere in the brain (including in the hypothalamus where it's a hormone and not a neurotransmitter, and may reduce the effect of orgasms) can do anything. there's a sort of push-pull between sexual excitement, dopamine and prolactin, and by increasing dopamine you may have killed one half of the feedback loop  thus less of a rush of dopamine on excitement and less of a rush of prolactin on orgasm.


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## jim_morrison (Aug 17, 2008)

Diya said:


> ADD and SAD basically. It worked so well for both during the first couple of weeks, but it stopped working for SAD after the initial euphoria wore off. It gives me energy at 5mg and higher and I can concentrate better on things.
> 
> I tried an SSRI called Zoloft for 7 months before @ 150 mg. In most cases, SSRIs either cause inorgasmia or libido loss, but that was never the case with me. If anything, SSRI improved the quality of orgasms.
> 
> On the other hand, a dopaminergic MAOI like selegiline that is supposed to have a positive sexual impact completely destroyed my libido. I guess my brain is just weird like that.


I'm kind of suprised to hear that your taking selegiline for something other than parkinsons to be honest, but I guess since you suffer from both ADD and SAD your wanting something that hits dopamine, perhaps your better off with something like ritalin, or a combination of ritalin + an SSRI.


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## jim_morrison (Aug 17, 2008)

Diya said:


> You can't get Ritalin nor Adderall prescribed in my country where they treat ADD with nootropics because it's "safer on the long run". It's ridiculous. I tried wellbutrin before and it didn't do much, so I'm left with selegiline.


What dosage did you take of wellbutrin? my understanding is that it's commonly underdosed, due to being fairly unpotent.


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## jim_morrison (Aug 17, 2008)

I think it's more prominent effects come out at 300 or so mg.


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## soaringfalcon11 (Jun 7, 2009)

jim_morrison said:


> I think it's more prominent effects come out at 300 or so mg.


I took 300 mg of SR for a week with 20 mg of Celexa. All it did for me was kill the anti-anxiety effects of the Celexa and increase my libido. Besides that, nothing, not even an energy boast.

It was originally meant to be prescribed at doses of 400 to 600 mg, but when the seizure rate at those doses was too high, they pulled it and re-released it with a max dose 300 mg.

I may mess around with it at higher doses just to see what happens.


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## jim_morrison (Aug 17, 2008)

I think its way over rated as a dopaminergic med personally. But it seems to be the best that alot of people can get their hands on unfortunatly.


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## beaches09 (Feb 1, 2009)

Hey pretty cool. I did this recently for about 10 weeks. I was trialing in 30-60mg doses. It takes on a different feel at 30mg and every 10mg over. 20-25 did cause anxiousness and some irritability at times depending on events for me but as soon as I would pop past the 30 mark everything would smooth out. I could write paragraphs about the whole experience.

One thing about that article stating that high doses decrease tyrosine hydroxylase is that it says they were dosing rats at 10mg/kg. Correct me if I'm reading that wrong it does seem overkill but if that were the case that would basically be 500-1000mg for the average human.


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## Medline (Sep 23, 2008)

beaches09 said:


> One thing about that article stating that high doses decrease tyrosine hydroxylase is that it says they were dosing rats at 10mg/kg. Correct me if I'm reading that wrong it does seem overkill but if that were the case that would basically be 500-1000mg for the average human.


One can't make this calculation as rats tolerate much higher doses of most substances compared to their body weight than humans. You can look at the LD50 of many drugs from rat studies (the dose where half of them die) and realize that the same mg / kg dose would most likely kill 90-100% of human beings.


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## beaches09 (Feb 1, 2009)

Hey what's up man  I thought so, that seemed extremely high and didn't sound right.

What do you think from info you have gathered? I wonder if 30-60mg dosing for humans then would cause problems with the tyrosine conversion. That gets me thinking what the difference between that and other MAOI's in regards to that would be then and why Selegiline would be singled out.


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## Medline (Sep 23, 2008)

I will look into this.


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## beaches09 (Feb 1, 2009)

Cool Medline that will be awesome to hear what you find out.

That's interesting Diya. I wonder if you could be one of those people that just has an opposite effect in most things. You could possibly consider that in your strategy in trying to find a cocktail.

I was thinking of making a thread of the experience and detailed log report just for kicks. If I can get the chance. I've gotta say, I was very impressed by it. Especially when I started drinking protein shakes with it wow. The first 6 weeks it was very activating and wonderful I realized what it was like to feel so alive again in more than half a decade, but then things started getting weird. I took a tiny amount of mirtazapine as a test around that time so it's possible that had something to do with it. I finally figured for me things got better again and the best effect was achieved when I would take 40mg and then for 3 days take 10mg, and rotate like that continously. lol Either that or a steady 30mg every day.

I am still taking 10mg now have been for a week. One more week to go then I plan to add an SSRI to the mix and give that a try. Combined with protein shakes to boost neurotransmitter levels, and I'm going to get some huperzine-A and or maybe try small amounts of a nicotine patch for acetylcholine.


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## jim_morrison (Aug 17, 2008)

Diya said:


> What's the complete opposite to Mirtazapine? An agonist at 5-HT2A, 5-HT2C, and 5-HT3. I guess the closest I can get to that is an SSRI, but SSRIs didn't work for me.


well most potent 5-HT2A agonists are classed as hallucinogens ie LSD, magic mushrooms etc, however interestingly, some have experimenatlly been shown to reduce OCD (not something I'd recommend trying at home though). 
However OCD symptom relief from LSD might be more suggestive of hallucinogen-induced 5-HT2A receptor down-regulation.
As for 5-HT2C receptors, both agonists and antagonists for that receptor type can produce and exacerbate symptoms of OCD, paradoxically.

ref: http://www.erowid.org/references/refs_view.php?A=ShowDoc1&ID=6318


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## beaches09 (Feb 1, 2009)

In my opinion it's reasonable to assume the negative effects you had on Mirtazapine were from the increase in NA. That would also explain the negative effect you experienced with Selegiline. 

In my experience doses over 30mg for Mirtazapine caused aggression and irritability for the first few days and then subsided after a week. 

I hear you say that benzos were the best thing for you. Without wanting to rely on those, or getting stims or maoi's, have you thought about giving Paxil a try? Of all the meds I've tried it was definitely the most anxiolytic, the complete opposite of Prozac and Zoloft. The lower doses anything under 30mg even helped me with concentration and focus tremendously. Over 40mg though had the opposite effect in that regard. I see you're on a mission to find the right thing for you, it couldn't hurt to give it a whirl.

I did something kind of cool the other day that I am still touching up when I get the chance and I'm finding it amusing. I think I will share the example in a thread a little bit later. I am finding it very helpful in looking at the different things I have been on and evaluating them, you guys might get a little kick out of trying it too.


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## beaches09 (Feb 1, 2009)

Go with your gut. If you are wanting Nardil the most and are able to obtain it then I am a person that will say just do it  There's nothing wrong with going for what you want.

Just a note on the pax, anticholinergic properties are definitely a turn off but it was completely absent in my case as long as I stayed under 30mg. I don't remember if it was 10 or 20mg that I started off with, but I remember that whole first month I immediately went from doing absolutely nothing and sitting around, and not to sound lame but to playing online chess like 12 hours a day and becoming freakishly good as hell at it in a very short time. Just to give an example of the effects it had on my brain in playing a very strategical and analytical game. A few weeks later I got the best job of my life, got promoted continuously for superb performance, and had some of the best times of my life.

The withdrawal was physical and definitely noticeable but not unbearable by any means. When I was taking it I was working out at the gym all the time and I had gotten in pretty awesome shape. When I stopped taking it for about two weeks my entire body just shrivelled up like a raisin and I had lost all my strength. It's funny to say, because I would work out with other guys in the gym and we would compete against each other etc. And when this happened I walked in and the look on their face was pure astonishment. The physical difference were as if I previously had been taking taking steroids which I wasn't of course, and then completely stopped. lol. It was temporary though and went away pretty quickly. That was coming off of 40mg cold turkey after a year. The mental withdrawal was nothing, although I seamlessly transitioned to wellbutrin which probably picked up the slack.


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## euphoria (Jan 21, 2009)

Diya said:


> I guess my body is weird like that. I mean, I'm also the only person on board who found Mirtazapine extremely anxiogenic while it shouldn't be in the slightest. Mirtazapine amplified my social anxiety AND gave me insect phobia as a bonus.


I noticed that mirtazapine's weak [alpha-2] adrenergic effects disappear within a few weeks, as beaches09 indicated. The minor tachycardia and anxiogenic effect disappears along this time scale.


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## Beggiatoa (Dec 25, 2004)

Selegiline also let me down. I had high hopes for it but it messed me up. Tyrosine, which previously worked so well for me, stopped working after I used deprenyl.

I'm into manganese now. It's a cofactor for the production of dopamine and I am having much luck with it. This means, virtually no SA.


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## jim_morrison (Aug 17, 2008)

Diya said:


> Alright, I'll start with that option. Mainly because I'm in the middle of the summer holiday and I'm not going through many social situations. I could try the other ones later when school starts since they are way more easy on my state of mind compared to Remeron.
> 
> I can't believe I'm getting back on this vile drug, and for a whole month. I'll probably start writing warnings all over the walls and the ceiling.


Good luck, it's funny how oppositely me and you react to mirtazapine. Without iI think I'd go nuts.


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## IllusionalFate (Sep 10, 2008)

Diya, have you considered a combination of low-dose selegiline (or other MAO-B inhibitor) with PEA? I don't know what the laws in your country are but I'd be surprised if PEA wasn't available OTC.

If I didn't have access to Schedule II stimulants, I'd try this combo right away and maybe add an NRI to get the most out of the cocktail. Since beta-Phenylethylamine (PEA) is a releasing agent which is a substrate for the DAT and NET transporters, using selegiline to make it active through oral administration should produce similar, if not the same effects as racemic or dextroratory amphetamine. Another benefit is that you're in control of the dose so you don't need to go through a hack middleman (ie. psychiatrist) to find your ideal dose.

This is a very promising cocktail for both AD[H]D and SAD. If you decide to try it, start with 5mg selegiline and 50mg PEA, then increase the PEA dose in 25-50mg increments while monitoring blood pressure until you find an efficacious dose.


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## beaches09 (Feb 1, 2009)

Best of luck of course. If I am to understand it right though aren't you then deciding to go back on one of the things that did you the most harm?

Don't get me wrong and of course everyone is always different. I think Mirtazapine is a great drug for deep depression and kicking it to the curb. It's not like a light switch waking up effect, for me it put me in even more of a cloud, but instead of death and despair it was happy and positive, but not really constructive. From my experience the negative benefits of wanting to sleep all the time and the unbearable disabling brain fog are what completely killed it, which I noticed you are having concerns about. The fog was so bad I would put off even writing back to people's simple emails because I couldn't put sentences together in my mind. For social anxiety the drug also had really no positive benefit in that area. Maybe a few points improvement probably from the greatly decreased general anxiety, but nothing spectacular. But it will make ya feel pretty good  lol

I get where your mind is at though, completely. Confusion can be a bi'tch.


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## jim_morrison (Aug 17, 2008)

beaches09 said:


> Best of luck of course. If I am to understand it right though aren't you then deciding to go back on one of the things that did you the most harm?
> 
> Don't get me wrong and of course everyone is always different. I think Mirtazapine is a great drug for deep depression and kicking it to the curb. It's not like a light switch waking up effect, for me it put me in even more of a cloud, but instead of death and despair it was happy and positive, but not really constructive. From my experience the negative benefits of wanting to sleep all the time and the unbearable disabling brain fog completely killed it, which I noticed you are having concerns about. The fog was so bad I would put off even writing back to people's simple emails because I couldn't put sentences together in my mind. For social anxiety the drug also had really no positive benefit in that area. Maybe a few points improvement probably from the greatly decreased general anxiety, but nothing spectacular.
> 
> I get where your mind is at though, completely. Confusion can be a bi'tch.


Yeah I did find that mirtazapine braught me out of a deep depression where SSRI's failed to, it didnt cause the mood numbing effects of SSRI's either. I did find the excesive drowsiness/sleeping side effects a bit anoying at 45 mg though, but at 30 mg's I'm dont get that problem, it probly helps that I suffer from insomnia and melancholic depression though (ie loss of appetite and insomnia) so those side effects don't bother me as much as they would bother say a person who suffers from atypical depressin (sleeping and eating too often). I guess what it all boils down to is that everybody is different so one persons cure may be another persons poison.


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## jim_morrison (Aug 17, 2008)

Diya said:


> I'm under the effect of Mirtazapine as I'm writing this. I realize now why I wrote that warning. I feel dysphoric, I always crave music when I wake up and listen to it for hours during the day, but now I just feel empty and drowsy/stoned/zombied/sluggish/foggy.


Mirtazapines immediate effects are those of a hypnotic (hence the nighttime dosing) so I'm not suprised that your feeling drowsy/stoned/zombied/sluggish/foggy.

Not sure about this "demon vision" thing though, lol

how much did you take anyway?


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## IllusionalFate (Sep 10, 2008)

Diya said:


> Yes, I've considered it. Ready for the surprise? PEA isn't available at all. Hell, I couldn't find tyrosine except in a very large supplement that contained hundreds of other things in a powder form that tastes like chocolate. I bought it and of course it had no effect whatsoever so I eventually consumed large portions of it because I like chocolate!!  tastes good. At least my money wasn't wasted.


There's always the internet...


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## jim_morrison (Aug 17, 2008)

Diya said:


> I took it yesterday before going to bed. I slept for more than 12 hours, and I woke up a couple of hours ago. Still feeling drowsy. As for the altered vision, it lasts throughout the experience. When my vision returns to normal I know that I'm no longer under the effect of Mirtazapine.
> 
> I think it's a mild visual hallucination. My current dose is 15mg. Anything higher than 30mg gives me insect phobia and peripheral hallucination. 30mg gives me hypomania on some days, so I'll stick to 15mg for a couple of weeks before upping to 30mg.


That sucks, sounds like and adverse reaction, officially the information states that hallucinations occur in 1/100 people on it. Are you sure you should keep taking it?


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## jim_morrison (Aug 17, 2008)

Diya said:


> Well, I'd be happy to try anything that would work. Basically, I tried everything that is available to me. Anything else is either way too expensive or neurotoxic, or both. (i.e. Amphetamine).
> 
> Maybe I could try PEA + Selegiline. I have to be extremely careful with that combination though. I'm not sure if it's going to work on a long term basis, but I'm willing to give it a go.


I'd stick to antidepressants if it was me, if nothing else works, then perhaps a more powerful AD combo such as california rocket fuel, nardil or parnate. Any of those in combination with a benzo prn.


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## Medline (Sep 23, 2008)

http://purebulk.com/phenylethylamine-hcl

Personally I doubt Selegiline + PEA is a long-term solution because of it's short duration of action. Very slowly increasing the PEA dose, measuring heart rate and blood pressure regularly and having carvedilol & benzos at hand is recommended (taking carvedilol 1 hour before the PEA is probably a good idea). An NRI like Reboxetine could be used in theory to counteract the cardiovascular effects of Selegiline + PEA, but I have never tried that, so I don't know if it works in reality.


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## beaches09 (Feb 1, 2009)

I feel that curiosity, nothin wrong with wanting to try stuff. Yeah def 4 days is way too quick to determine good effects vs bad ones for a med =P Actually I think it's pretty much mandatory for most non-fast acting meds to expect to feel worse for at least the first week.

I wouldn't recommend PEA as a long term solution. Short term fun or creative tasks sure. I've even used super small doses while taking high unselective doses of selegiline (not recommending this of course). It's definitely all it's hyped up to be, but it wears off too fast and you have to keep dosing and the more you dose the more your blood pressure gets all effed up so like these guys say you have to take other stuff with it. If one is determined enough to take the time in figuring out the perfect tweaking for it with the right combo of other ingredients, then I could see how and why it could be used as a drinking replacement things like that etc, for when you go out. For concentration purposes I found to start from the lowest dose possible and try to completely avoid the euphoria. For that purpose I've gotten it to last about as long as Adderall for a single dose. As Illusion indicated in that case, it is a great Adderall alternative. You really gotta be careful with it though and make sure to be taking lots of amino acids and vitamins/minerals to keep your transmitter stock at a healthy level, because otherwise it will deplete you.



jim_morrison said:


> it probly helps that I suffer from insomnia and melancholic depression though (ie loss of appetite and insomnia) so those side effects don't bother me as much as they would bother say a person who suffers from atypical depressin (sleeping and eating too often). I guess what it all boils down to is that everybody is different so one persons cure may be another persons poison.


Great point. This med would be great for insomniac and super high general anxiety types. I am definitely an A-typical type.


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## jim_morrison (Aug 17, 2008)

Diya, have you tried an SNRI? might work slightly better on the combo of anxiety/OCD + ADD than an SSRI. Since SNRI's are sometimes prescribed off label to treat ADD/ADHD. Just a thought.


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## Medline (Sep 23, 2008)

You had a working combo (I think it was sulpiride + bupropion) but you stopped it. I know your reasons, but if were I you I would have continued taking the meds.


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## beaches09 (Feb 1, 2009)

jim_morrison said:


> Mirtazapines immediate effects are those of a hypnotic (hence the nighttime dosing) so I'm not suprised that your feeling drowsy/stoned/zombied/sluggish/foggy.


I've heard it rumored as being called the "stoner's drug" lol.

I'll never forget how it made me feel after popping my doses after 3 weeks. 30-45 minutes of absolute bliss. Get that effect to last all day and ditch those brain fog/sleepy properties and that would be some good stuff


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## beaches09 (Feb 1, 2009)

Damn i can't wait. 5 more days and I'll be adding an ssri to my mix.


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## jim_morrison (Aug 17, 2008)

beaches09 said:


> I've heard it rumored as being called the "stoner's drug" lol.
> 
> I'll never forget how it made me feel after popping my doses after 3 weeks. 30-45 minutes of absolute bliss. Get that effect to last all day and ditch those brain fog/sleepy properties and that would be some good stuff


Lol its probly referred to as a stoner drug coz it makes you want to eat and sleep soo much 

I don't get any immediate bliss from it, unfortunatly, but when I was taking 45 mgs I'd be in a state of constant mild euphoria, it wasnt an immediete effect though, it was more like an effect that built up with a few weeks of chronic dosing.

PS - as for the brain fog thing, it's supposed to be mildy nootropic, oddly enough.


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## beaches09 (Feb 1, 2009)

Really? that's cool. I only gave 45 a try for about 1-2 weeks I should have kept it up, the sedation got higher so I lowered it back. When I dosed 45 I had an euphoric effect like that too but it would last about 45 minutes. I would be listening to my music and all of a sudden it would kick in and it was boom, I felt much more inside the music as if were all around me and I was at a live concert. Like an awakening kind of feeling, different from the lovey peaceful feelings at 30mg. But after an hour the histamine would hit me and I'd be out like a light. 

Interesting you mention that, I did have some times of intense creativity. The execution speed on the other hand was incredibly slow because of all the fog I had to sift through. Like I did some extremely creative stuff, but it took days and nights of constant hours. It was like I had the right ideas to create awesome things, but I was in a super rainstorm trying to find the clear. Where as say an Adderall I would have been done with it in a flash. lol


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## beaches09 (Feb 1, 2009)

I've tried Selegiline with Bupropion a handful of times.

For me I found it didn't make bupropions effects any more positive than using the med alone. What it did do though was allow a MUCH lower dose to be used. For example I never took more than 25mg of it in combination with selegiline. And even the 25mg had a noticeable effect. But not better. I would be afraid to try higher. I think I could probably do 50mg and be alright. This is coming from a guy that was on 300mg daily previously. lol. I was thinking an idea like this would be best implemented for someone that was taking wellbutrin for a while and it started pooping out, then start adding 1mg of selegiline very very slowly little by little over the course of some weeks.



Diya said:


> Selegiline + Sulpiride, which I've never talked about, was absolutely amazing. I felt random surges of happiness and social anxiety was non-existent. It lasted for a couple of days and then I was back to my old self. It was placebo.


This is very interesting I need to look into this med  So this combo was amazing but then got worse or you just didn't want the side effects so you stopped?


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## beaches09 (Feb 1, 2009)

Got ya, don't ya hate when that happens


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## jim_morrison (Aug 17, 2008)

Diya said:


> Nope, I've never tried an SNRI. I figured that since a TCA (which is basically a 'dirty' SNRI) and a couple of SSRIs didn't work for me, then SNRI's won't work either.
> 
> Thanks all for the advice.


The SRI of SNRI's is stronger than that of most TCAs, with the exception of clomipramine, so it's a bit more like a clean version of clomipramine I guess, rather than the other TCAs. 
Maybe the 2 would work best in syncronization, like with an SNRI, thats just speculation though, I'm not sure.


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## jim_morrison (Aug 17, 2008)

beaches09 said:


> Really? that's cool. I only gave 45 a try for about 1-2 weeks I should have kept it up, the sedation got higher so I lowered it back. When I dosed 45 I had an euphoric effect like that too but it would last about 45 minutes. I would be listening to my music and all of a sudden it would kick in and it was boom, I felt much more inside the music as if were all around me and I was at a live concert. Like an awakening kind of feeling, different from the lovey peaceful feelings at 30mg. But after an hour the histamine would hit me and I'd be out like a light.
> 
> Interesting you mention that, I did have some times of intense creativity. The execution speed on the other hand was incredibly slow because of all the fog I had to sift through. Like I did some extremely creative stuff, but it took days and nights of constant hours. It was like I had the right ideas to create awesome things, but I was in a super rainstorm trying to find the clear. Where as say an Adderall I would have been done with it in a flash. lol


Yeah, but I had the same problem as you, that is, the higher the dosage I went up to, the more sedation I experienced, it's a shame, coz I would have loved to see what 60 mgs could have done for my depression.


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## euphoria (Jan 21, 2009)

jim_morrison said:


> That sucks, sounds like and adverse reaction, officially the information states that hallucinations occur in 1/100 people on it. Are you sure you should keep taking it?


Personally I don't trust the official side-effect lists, as they have a massive conflict of interest in selling these drugs...

I get mild psychedelic effects from dosing 30-45mg upwards, but you'd probably need quite a high dose for full hallucinations. They definitely happen though for some, and in a dose-related way.

Overall mirtazapine has good and bad effects, as do SSRIs, and neither [alone] are amazing by any stretch of the imagination. The good vs. bad ratio seems much more in favour of good when combined with general serotonergics (SSRI/SNRI/etc.), though, with the resulting effect being more than the sum of its parts due to more intelligent serotonergic manipulation. So to Diya I give my usual advice: get some "rocket fuel" up yo' ***! It will be different to either drug alone.

I'm drooling even thinking about a SSRI/mirtazapine/selegiline cocktail, but dunno how safe it'd be...


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## jim_morrison (Aug 17, 2008)

It's odd, even at 45 mgs I never had the slightest hint of hallucinations, I took a dose of mirtazapine 4 hours ago actually, and I feel perfectly normal right now.

Euphoria; I know theres some debate over whether mirtazapine is serotonergic or not as discussed in some other threads, whats your opinion?


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## jim_morrison (Aug 17, 2008)

Diya said:


> Rocket fuel is SNRI + Remeron though, right?


Certainly is, and the most commonly used SNRI used in rocket fuel is Effexor XR.


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## euphoria (Jan 21, 2009)

jim_morrison said:


> It's odd, even at 45 mgs I never had the slightest hint of hallucinations, I took a dose of mirtazapine 4 hours ago actually, and I feel perfectly normal right now.
> 
> Euphoria; I know theres some debate over whether mirtazapine is serotonergic or not as discussed in some other threads, whats your opinion?


I personally think most of mirtazapine's beneficial effects come from its antagonism of various serotonin receptors, rather than the weak a2 blockade. Still, anything that interacts with serotonin neurotransmission is "serotonergic", so the classification is right.



Diya said:


> Zoloft + Remeron, wow two drugs that I had a bizarre reaction to. I could go either completely crazy or completely cured.
> 
> Rocket fuel is SNRI + Remeron though, right?


It should also work with SSRI + mirtazapine, although maybe sedation & weight-gain would be worse than with SNRIs. As usual, you shouldn't expect benefits from the SSRI until a number of weeks have passed, but mirtazapine should block some of the initial side-effects.


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## jim_morrison (Aug 17, 2008)

euphoria said:


> Still, anything that interacts with serotonin neurotransmission is "serotonergic", so the classification is right.


Lol yeah I thought that after I wrote it, I probly should have phrased it better.


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## jim_morrison (Aug 17, 2008)

euphoria said:


> It should also work with SSRI + mirtazapine, although maybe sedation & weight-gain would be worse than with SNRIs. As usual, you shouldn't expect benefits from the SSRI until a number of weeks have passed, but mirtazapine should block some of the initial side-effects.


I tend to think that SSRI's will exacerbate her ADD somewhat.


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## euphoria (Jan 21, 2009)

In that case, she has plenty of selegiline to add on top of the other two. This is uncharted territory, but I don't see any reason why it'd be dangerous.


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## jim_morrison (Aug 17, 2008)

Apparently Modafinil is available in india, perhaps that would help with the ADD component.


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## jim_morrison (Aug 17, 2008)

Effexor is a somewhat more potent serotonin reuptake inhibitor than it is for NE, hence lower doses it can act selectively as an SRI, however at higher doses (about 150-200 mg +) it starts to act as an SNRI, it's metabolite pristiq (desvenlafaxine) however is a more potent NE reuptake inhibitor than venlafaxine. Effexor also appears to have a synergistic and potentiating effect when combined with mirtazapine, giving a much stronger antidepressant effect than either agent alone.


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## jim_morrison (Aug 17, 2008)

Wow those prices are ridiculous, do they have generics in your country? Because i think that all of the meds you listed, (bar nardil), are available in generic form now.


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## jim_morrison (Aug 17, 2008)

euphoria said:


> I personally think most of mirtazapine's beneficial effects come from its antagonism of various serotonin receptors, rather than the weak a2 blockade.


Personally, I tend to agree with Dr Stahl's theory that mirtazapine acts as a Serotonin, Norepinephrine and Dopamine Disinhibitor, serotonin & norepinephrine (via a2 antagonism) and dopamine & norepinephrine (via 5HT2c antagonsim), I think that this may adequately explain it's superior efficacy in treating depression compared with trazadone (which acts primarily as a 5HT2c/a antagonist).

Combine that with the monoamine reuptake blockade caused by a high dose of effexor, to keep the disinhibited monoamines in the synaptic cleft for even longer, and it's no wonder that california rocket fuel is a powerful combo.


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## nowheretohide (Aug 20, 2009)

Hi!

Iam on cymbalta+remeron combo. I started it on the 20th of august so I have been on it for more than one week. I started taking 30mg remeron and 60mg cymbalta the first week and increased the dosage to 60mg remeron and 120mg cymbalta after the first week. I think its working eventhough I have been on it for less than 2 weeks. I feel less anxious when Iam out in the public and Iam able to think and talk more clearly. I hope it keeps getting better and the anxiety subsides. I live in sweden and 29 years old. I havnt tried many SSRIs or SNRIs prior to this combo. I have gained a couple of kgs since starting remeron, besides that the side effects hav been minimal. I felt sedated and tired only the first day.


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## euphoria (Jan 21, 2009)

jim_morrison said:


> Personally, I tend to agree with Dr Stahl's theory that mirtazapine acts as a Serotonin, Norepinephrine and Dopamine Disinhibitor, serotonin & norepinephrine (via a2 antagonism) and dopamine & norepinephrine (via 5HT2c antagonsim),


Agreed, but its affinity for the a2 receptor is 10 times lower than that of the three 5-HT subtypes (3, 2A and 2C).



> I think that this may adequately explain it's superior efficacy in treating depression compared with trazadone (which acts primarily as a 5HT2c/a antagonist).


Trazodone also metabolises to mCPP, which acts as a 5-HT2B/C agonist. If enough of trazodone ends up as mCPP, this could lessen positive effects obtained from 2C antagonism and even go in the opposite direction the day after, due to trazodone's short half-life. There's also the heart toxicity thing already proven a risk with 2B agonists, such as ergot derivative dopamine agonists, and the anorectic drug fenfluramine.

http://www.australianprescriber.com/magazine/31/1/artid/939/



> Hi!
> 
> Iam on cymbalta+remeron combo. I started it on the 20th of august so I have been on it for more than one week. I started taking 30mg remeron and 60mg cymbalta the first week and increased the dosage to 60mg remeron and 120mg cymbalta after the first week. I think its working eventhough I have been on it for less than 2 weeks. I feel less anxious when Iam out in the public and Iam able to think and talk more clearly. I hope it keeps getting better and the anxiety subsides. I live in sweden and 29 years old. I havnt tried many SSRIs or SNRIs prior to this combo. I have gained a couple of kgs since starting remeron, besides that the side effects hav been minimal. I felt sedated and tired only the first day.


Consider that a very good sign then. Your response should build to an even greater level as you pass the 2-4 week mark [since altering dose]. I'm jealous...


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## euphoria (Jan 21, 2009)

Diya said:


> 420


:cig

Diya, you should ask your pharmacist for generic drugs to reduce the prices. Pfizer and GlaxoSmithKline are both gonna be more expensive than generic.


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## jim_morrison (Aug 17, 2008)

euphoria said:


> Agreed, but its affinity for the a2 receptor is 10 times lower than that of the three 5-HT subtypes (3, 2A and 2C).


what dosage of mirtazapine do you think is necessary to get a decent amount of the a2 antagonist action happening?



nowheretohide said:


> Hi!
> 
> Iam on cymbalta+remeron combo. I started it on the 20th of august so I have been on it for more than one week. I started taking 30mg remeron and 60mg cymbalta the first week and increased the dosage to 60mg remeron and 120mg cymbalta after the first week. I think its working eventhough I have been on it for less than 2 weeks. I feel less anxious when Iam out in the public and Iam able to think and talk more clearly. I hope it keeps getting better and the anxiety subsides. I live in sweden and 29 years old. I havnt tried many SSRIs or SNRIs prior to this combo. I have gained a couple of kgs since starting remeron, besides that the side effects hav been minimal. I felt sedated and tired only the first day.


Sounds cool, latly I've actually been thinking about asking my pdoc to add 150 mgs of effexor XR to my mirtazapine.


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## jim_morrison (Aug 17, 2008)

Diya said:


> Well, I don't know what you mean. There is "Pfizer" and "GlaxoSmithKline" written on Zoloft (Lustral) and Paxil (Seroxat) respectively. "Organon" written on Remeron. "N.V. Organon Oss Holland"
> 
> With 420 (The price of Rocket Fuel), I can buy 12 large-sized stuffed crust pizza's from Pizza Hut. Just to give you an idea of the price. It could feed a family, and that's just on the lower doses. I'll probably have to double the doses eventually that's 24 large-sized stuffed crust pizza's lol :/
> 
> I won't have enough money to even feed myself. Sorry for the money rant, I'll just accept the facts and go on Paxil + Remeron instead. If it didn't work then maybe a TCA + Remeron.


Hope i'm understanding your question right; A generic medication is, when a medicine goes off patent after a certain amount of years - for example "pfizer" loses the patent on zoloft, other "generic" brands are then allowed to produce the same product ie " generic sertraline". Generics are usually much cheaper.


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## euphoria (Jan 21, 2009)

jim_morrison said:


> what dosage of mirtazapine do you think is necessary to get a decent amount of the a2 antagonist action happening?


I'm not sure. Seems logical that it'll happen at all doses, just to a lesser extent than the serotonin blockade. User reports suggest higher doses are more stimulating, which would figure.

alpha-2 antagonists are known for producing anxiety, and also, alpha-2 receptor abnormalities have been associated with anxiety disorders.


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## jim_morrison (Aug 17, 2008)

Ever since I've dropped the dose back to 30 mg I've been starting to feel depressed again, think I'll need to bump it back up to 45-60 mg and/or possibly add effexor to boost it.


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## nowheretohide (Aug 20, 2009)

Hi again!

Just a little update about me and how the combo is working. I was out all day with little or no anxiety. I had acouple of beers while I was watching a soccer game, but I wasnt drinking to reduce my anxiety. I would recommend the california rocket fuel to anyone its very potent against Socail anxiety.


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