How Bad Is Lowering MAO-A For Raising Serotonin?

[Energizer]

Background: I'm seeing a psychiatrist for clinical depression. I've been taking selegeline 10mg in the morning daily for the depression. (I also take 4 grains of Westhroid-P, but am not as far as I know, anywhere near hyperthyroid, I only eat 1500 - 2000 calories a day, and don't have much appetite to eat more than that, I'm also slightly overweight). He wants to raise the dose to a "therapeutic" level up to between 30-50mg. My concern with that is the MAOI would be unselective, possibly raising serotonin too much and counteracting the good effects of increasing dopamine, acting almost like an SSRI. Is this assessment accurate?

 

[InChristAlone]

I don't have any advice on the antidepressant, but sounds like you could use more food and carbs? High adrenaline can leave you feeling pretty hopeless, and if you are pushing g thyroid without enough fuel that could cause low blood sugar and chronic depressive like symptoms.

 

[Stryker]

wow thats alot of selegiline!
i think 20 mg can still be taken safely by some... 30-50mg sounds concerning and it definately loses its selectivity at that amount.

imo i never noticed any change from taking selegiline even after about 15 months of administration with 3 different brands of selegiline hydrochloride and another brand of selegiline citrate.

i think i might crush whatever remaining selegiline i have left and make a solution with DMSO and try the transdermal route (EMSAM patches)

if money isnt that big of a deal for you i would give the russian medication Ladasten a try which works by increasing dopamine via Tyrosine Hydroxylase instead of inhibiting its breakdown

 

[Energizer]

Thanks for the responses guys, I appreciate the input.

 

[DaveFoster]

You have to get your diet nailed, then your gut and liver in check. If you get these two things, then thyroid will work for you. Synthetic T3 (with T4 of course) will be more potent than your current medication. For high adrenaline, salt can be very helpful, but at the end of the day you need to improve thyroid function and lower serotonin and adrenaline.

Some people benefit more from higher T3 to T4 ratios. Ray's said that many feel optimal on a 3:1 ratio T4:T3, rather than the 4:1 commonly prescribed.

What's your diet?

Try methylene blue as well (200-400 mcg), but start at 50 mcg or lower.

For me, pregnenolone and DHEA (via haidut's Pansterone) helps me. The androgens are important for maintenance of your biological structure, and these will facilitate their production.

 

[Energizer]

I drink at least half a gallon of milk a day, sometimes an entire gallon. Sometimes a glass of OJ. Today I had a can of oysters as well. Usually two eggs in the morning. My appetite is low usually, so I have to force food down, or just drink milk (which I don't mind anyway, cause it tastes good). I've been taking caffeine pills which I'm sure are responsible for my lowered appetite, but the energy boost is irreplaceable. I know my diet is far from ideal, but even just eating enough calories for me is a victory.

I haven't had any cravings for meat lately, in fact the thought of eating steak makes me feel slightly sick, yet I have little problem with oysters.

My psychiatrist insists on putting me on a 20mg dose of selegeline/l-deprenyl, so today I unfortunately for him lied and told him I would take the 20mg, but I really don't have any intention to take more than 10mg, as I'm concerned about the higher doses raising serotonin more due to the MAO-A inhibition (not to mention if I slip up and eat the wrong food, it's to the hospital I go). I tried explaining this rationale to him, albeit it proved futile, as most occasions of debating the psychiatrist do. I considered discontinuing seeing him, but I think he has some useful life advice, and I've been suffering from isolation and depression for so long now that I feel like it's a struggle to climb out of the rut I'm in alone.

I definitely want to try Methylene Blue, hopefully down the road when I'm not taking selegeline.

 

[Westside PUFAs]

Are you still smoking tobacco?

 

[Energizer]

I'm not smoking right now, I wish I was. It's not allowed where I live.

 

[DaveFoster]

@Energizer

I empathize with you. I'm an absolute wreck when it comes to learned helplessness, depression, and loneliness. I need my supplements to stay sane.

The best thing you can do is to start taking glycine:

-20-60 grams glycine/day in milk with sugar (coffee optional) [nausea will set in if you take too much]

Tianeptine is another option (the sulfate or free acid is ideal due to its long half-life

- 25 - 45 mg tianeptine sulfate sublingually

Lysine is another great option:

- 500 mg - 2 grams lysine repeated as needed on an empty stomach with water + sugar as a liquid

Lastly, a combination of three things will help you to increase appetite, lower free fatty acids, and raise your oxidative metabolism:

- Niacinamide 100 - 500 mg/day orally (or haiduts Energin B-vitamin complex every morning [highly recommend])
- Pregnenolone 100 mg/day orally (plus optional DHEA 2-3 mg x3/day sublingually), again haidut's Pansterone is a good option
- Either caffeine (1-12 cups/day, so 50-600 mg caffeine w/ added sugar, more if you can tolerate, but I doubt that's plausible) AND/OR thyroid (T4:T3 in a 4:1 OR 3:1 ratio; maybe even slightly more T3)

I think there are benefits to doing both coffee and thyroid, as caffeine allows thyroid to enter the cells in the context of PUFA saturation.

Another few important things you can try:

- Cyproheptadine 2-8 mg/day (haidut just came out with ritanserin, a sister drug of cyproheptadine)
- Activated charcoal before bed (variable dosage) 2.5 grams every three days is a reasonable starting dosage
- Carrot salad w/ dressings

All of these are to reduce endotoxin and serotonin.

Ray's #1 recommendation is thyroid. With adequate thyroid function, everything falls into place in his view.