Selegiline is used together with levodopa and carbidopa to treat symptoms of Parkinson’s disease.
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Both L-tryptophan and 5-HTP have been used to treat depression. One controlled study showed that taking selegiline at the same time as 5-HTP enhanced the antidepressant effect when compared with 5-HTP alone.1 Further research is needed to determine whether taking selegiline and 5-HTP together might result in unwanted side effects.
Both L-tryptophan and 5-HTP have been used to treat depression. One controlled study showed that taking selegiline at the same time as 5-HTP enhanced the antidepressant effect when compared with 5-HTP alone.2 Further research is needed to determine whether taking selegiline and 5-HTP together might result in unwanted side effects.
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Ephedrine is an active ingredient found in ephedra, an herb that until 2004 was used in cold remedies and herbal weight loss products. One individual taking selegiline together with ephedrine experienced a serious side effect known as hypertensive crisis, in which blood pressure can reach dangerous levels.3 Though no studies have investigated whether the herb ephedra might result in similar effects, the current evidence suggests that people taking selegiline should avoid all products that contain ephedra.
Rarely, people taking selegiline might experience a rapid rise in blood pressure and a severe throbbing headache when the drug is taken with foods that contain tyramine, such as cheese (especially aged); sour cream; yogurt; alcoholic beverages; meat, fish, and poultry; a variety of fruits and vegetables, including avocados, figs, and eggplant; fava beans; some soups; and chocolate.4 One study showed that taking 30 mg of selegiline each day greatly increases tyramine sensitivity.5 It has therefore been suggested that people taking 30 mg or more of selegiline per day should consume a tyramine-free diet.
1. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137–46.
2. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137–46.
3. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1025–7.
4. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1025–7.
5. Prasad A, Glover V, Goodwin BL, et al. Enhanced pressor sensitivity to oral tyramine challenge following high dose selegiline treatment. Psychopharmacology (Berl) 1998;95:540–3.
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