Posted by SFY on June 16, 2006, at 13:04:10
After trying Requip to supplement my Nortriptyline failed to have any effect, good or bad, my next preferred option was to try Emsam. (I have dysthymia, anhedonia, amotivation, and social anxiety.)
Usually this would mean going off the Nortriptyline as it is clearly contraindicated with Emsam. However, right now I'm dealing with some difficult emotional upheaval in my life and don't want to go off meds especially one that seems to be providing some support against depression.
Despite the combination being clearly contraindicated in both meds' inserts, there are studies showing that adverse reactions are rare. This is especially true when one is already taking a Tricyclic and adds an MAOI to it.
I went into my pdoc's office with 5 pages of abstracts on these studies all set for his initial opposition to my plan. But he didn't even blink an eye - it turns out that years ago when he was in the UK (my pdoc is British), he and his colleagues would occasionally add an MAOI to a Tricyclic for treatment-resistant depression without any adverse effects. He just advised me to check my blood pressure at times (specifically by just stopping into a pharmacy with one of those free blood pressure testers) to make sure it wasn't elevated.
He also said he could give me some Emsam samples (I am his first patient to try it) which he had at his other office. I was a little wary when I picked up the samples the next day and he had me sign a waiver saying that I knew of the risks involved and taking him off the hook. Totally unexpected and it freaked me out a little but I knew there was a risk involved so I got over it.
I'm planning to start the Emsam on Sunday. I'm waiting because I have a party to go to on Saturday which will have a high tyramine menu. Plus on Sunday I'll be spending the day with my parents so just in case anything does go awry I won't be alone. (And then on Monday I'm scheduled to give blood so I'll get a blood pressure check).
I'll keep you all posted on my progress once I've been on it a few days (or when I first feel its effects, good or bad).
poster:SFY
thread:657616
URL: http://www.dr-bob.org/babble/20060610/msgs/657616.html