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antidepressants and herpes

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9 hours ago, MikeHerp said:

interesting.  Has anyone else tried this? 


I haven´t found more recent research, but as far as I know, its the first time anything reduces viral load in the ganglia...


Herpesviruses are highly prevalent and maintain lifelong latent reservoirs, thus posing challenges to the control of herpetic disease despite the availability of antiviral pharmaceuticals that target viral DNA replication. The initiation of herpes simplex virus infection and reactivation from latency is dependent on a transcriptional coactivator complex that contains two required histone demethylases, LSD1 (lysine-specific demethylase 1) and a member of the JMJD2 family (Jumonji C domain–containing protein 2). Inhibition of either of these enzymes results in heterochromatic suppression of the viral genome and blocks infection and reactivation in vitro. We demonstrate that viral infection can be epigenetically suppressed in three animal models of herpes simplex virus infection and disease. Treating animals with the monoamine oxidase inhibitor tranylcypromine to inhibit LSD1 suppressed viral lytic infection, subclinical shedding, and reactivation from latency in vivo. This phenotypic suppression was correlated with enhanced epigenetic suppression of the viral genome and suggests that, even during latency, the chromatin state of the virus is dynamic. Therefore, epi-pharmaceuticals may represent a promising approach to treat herpetic diseases.

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I actually talked my doctor into letting me try this a few years ago.  The safest way to take this type of drug (technically an MAOI) is via a patch called EMSAM https://www.emsam.com/ .  If you have commercial health insurance (i.e. through your employer) there's a card on the web site that allows you to pay only $20/month to get it.  Otherwise it's well over $500/month.

Let me start by saying that, if it made a difference, the difference was so totally overwhelmed by the side effects of the medication that I didn't notice.  It actually ended up landing me in the ER one day when I collapsed during a jog. 

The problem is that the inhibition of LSD1 is a secondary, much weaker, effect of this drug.  It's primary effect is inhibition of MAO.  To get to the HSV suppression effect you must take a very high dose.  For all practical purposes unrealistically high.  The maximum EMSAM dose has a lot of risks.  Doctors stopped using MAOi's because they have nasty cardiac effects when you consume typical amounts of certain foods.  Specifically those with tyramine which includes things like bananas, cheese, and yogurt.  Anyone on an MAOi is required to be on the MAOi diet.

The patch form supposedly helps reduce this effect because the drug avoids your gut via this pathway and interacts less with ingested tyramine before being metabolized.  However, even with that potential effect minimized, MAOi's in general tend to affect blood pressure.  In the absence of tyramine the drug lowers blood pressure, in the presence of tyramine it dangerously spikes blood pressure. 

Either way, the stuff should be avoided unless you have major depressive disorder, the current myriad of much better anti-depressants don't work for it, and you have a death wish.

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