Posted by laima on December 21, 2006, at 19:50:33
In reply to Re: Emsam enhancement/Helpful suggestions, posted by laima on December 21, 2006, at 19:14:57
I should clarify part of what I just posted- when I tried the 12 Emsam, it was because I still felt pretty un-ok and going downhill, so an increase seemed like a good thing to try. I believe I was using 15 mg ritalin per day at the time- might have been 20, but I can't remember. When I started the 12, immediately my blood pressure went way down, my pulse went way up- like 97! I was afraid to use the ritalin- and I had klonopin- but that didn't seem like a hot idea either. I didn't know what to do, and was pretty freaked out over what was happening. So I pulled of the patch and went to see the doctor the next day. He said that when the heart rate goes way up while blood pressure goes way down, that means the heart is working much harder to try to keep up. Not good. So, decrease of Emsam, elimination of ritalin, and start of klonopin withdrawal all at once. And why klonopin withdrawal- because we both agreed that after 4 years it probably wasn't doing much of anything for my anxiety, and probably contributing to both it and depression. At end of November, 10 mg ritalin reintroduced, and I felt better- but still blah, and quite discouraged. That's when I had the consultation with the other guy who had ideas about adderall. So now, just the Emsam 9 and the 10 mg adderall seems like the formula for me. I feel better than I have in a long while, my mood is greatly improved, and no more weird blood pressure or heart rate fluctuations. I'm not feeling jittery anymore, either, and I sleep much better. A lot of changes, rocky for a couple weeks-still not perfect- but overall much better and so worth it now.I haven't used wellutrin for over a year, and I had to let it flush out for awhile before starting any selegeline. Sorry if I wrote that in a confusing way.
> Do you know, when I tried the 12mg Emsam, my blood pressure absolutely tanked, so I had to go back to 9. (It was something like 92/61, even when I was moving around in the middle of the day! I felt pretty faint. I haven't felt any agitation from Emsam, as others have reported. In other words, as it was increased, I became more sluggish, to say the least.) With the 9, a grand total of 10 mg adderall per day is sufficient to keep my blood pressure at the low end of normal (in the neighborhood of 110/70 when moving around moderately), and it boosts my energy and mood as well as focus, etc. If I understand correctly what my doctor was saying and what I was reading, selegeline can somehow increase a stimulant's effects, so "less acts like more". Sounds like it could get dicey fast for someone with high blood pressure. Perhaps if your doctor wavers, you might offer to get a blood pressure reader and promise to monitor yourself? That would seem prudent anyway until you are very sure how you react. 10 mg adderall a day is a pretty low dose, I believe--but pretty effective with the Emsam. Interestingly, before I started using selegeline oral version, I was giving wellbutrin a fair trial, with the same doctor. I tried ritalin with it for awhile for ADD and sleepiness, but the combination left me pretty frazzled so it was stopped. Another interesting discovery is that my overall anxiety seems to have gone way down as I gave up klonopin and now added the adderall- go figure.
>
> > This is all very interesting and I thank you for your experiences with Ensam, selegiline and Adderall.
> >
> > I think, don't know for sure, that Ensam will be covered by insurance so I may not have to take Selegiline but I will print out your posts if I need to know equivalents. It sounds as though either 10 or 20 mg will be good starting point if I need to go there. I have taken Adderall in combination with Wellbutrin and Celexa and felt it helped with my symptoms of disorganization and lack of focus. When I stopped it I felt like it contributed to my downward spiral as I got more and more disorganized and eventually life seemed to get very overwhelming.
> >
> > My pdoc will say it is not allowed with Emsam but it may be helpful down the road. I also have suffered with hypotension, although recently it seemed more WNL.
> >
> > All of this information is very helpful. The 6 mg patch which I have been on for a month may not be enough since I'm starting to lose my energy level so perhaps I need an increase?
> >
> > Stargazer
>
>
poster:laima
thread:703921
URL: http://www.dr-bob.org/babble/20061217/msgs/715564.html