Posted by liliths on January 8, 2007, at 11:28:27
In reply to Re: EMSAM Q? » liliths, posted by laima on January 8, 2007, at 9:40:24
hi Liama,
I'm guessing that not having to be digested gastrointestinally probably has a lot to do with the patch not necessarily having dietary restrictions. Gee, I actually thought about it LOL
Thank you SO much for your info.
I seems to me that the blood pressure effects of the stims would be a 'good' thing, considering how low the MAOI's make it - I'm actually surprised to hear of the caution.
when I was on the nardil - I had to constantly take readings because my bp went so low, so I understand how what starts out interesting ends up annoying!
the few times I've missed my morning meds (accidently) I'd realize it only because I'd spend the day like a slug as well, only also crying a LOT and eating for 'comfort'
I'm pretty athletic - weight gain is a BAD thing LOL
Though my pdoc was among the first to tell me I'd have to be on meds the rest of my life (I'd always thought of them more as that 'window of opportunity' thing), he also told me that someone like me couldn't be helped by any pill unless I worked out regularly.
But the stupid pills do have to at least relieve some of the symptoms or else why take them? It doesn't help to 'know' working out will make me feel better if I can't go out of the house and do it!! That's what pissed me off about his unwillingness to realize the meds weren't working anymore.
I definitely agree that we have to change our lifestyles, habits, and behavior since depression as a lifestyle itself can become pretty addicting - no matter how miserable you are - it's the misery you know
Interesting information about the adderall - I'd definitely be willing to try it with the EMSAM and my klonopin if I can find a pdoc willing to do it.
what's the exchange for adderall? Is it like focalin, which is half what one would take on ritalin or concerta?
you've been great
thanks again
namaste,
lilith> Hi Liliths,
>
> The # 6 doesn't have any dietary restrictions, and I get a little sloppy sometimes following the restrictions with the 9, and everything's been fine. (Technically, dietary restrictions haven't been officially studied with the 9 or 12-so they have to warn people, and caution is prudent.) It's only the MAOI drug warnings which are in full and undisputed effect for all three. I'd say that dietary freedom and relaxation is the # 1 benefit of Emsam over oral selelgeline. My doctor also seems to believe that the selegeline is somehow absorbed by the body differently or more efficiently from Emsam, but I didn't quite catch the details of why he believes that. I've not associated any weight gain or increased appetite with any strength Emsam. I'm personally not so sure about the efficacy of the 6, however. My doctor even said that he went to an Emsam conference where there was talk between the doctors that most people started responding when the dose was at least # 9--though the 6 has helped a fair number of people. I'm using the 9 right now with 15 mg adderall (it went up!). With the adderall increase especially, it's working out alright. Winter has always been really tough for me, and the weather has been very dark lately... I think I could be much, much better, but I'm back to believing my doctor when he keeps emphasizing therapy and lifestyle adjustments. His mantra could be, "Medication while it works gives you a window of opportunity..." (Working on that!) I blew off those urgings in the past, but this time I am heading as best as I humanly can. It's so interesting, he's a psychpharmacology expert who doesn't believe antidepressents work indefinately, but that's a whole other thread and story. So I completely believe you when you say wellbutrin and buspar aren't doing much for you these days. I've been on Emsam or selegeline for a year, and my doctor told me it was indeed entirely possible that it's not as helpful for me now as it used to be- but that there should still be some mileage left. And finally- the low blood pressure has been the only side effect I've associated with Emsam- but adderall keeps that under control, so it's not a problem. On days that I take a break from a stimulant, I remain a weak feeling slug, even after the stimulant's washed out. That's how I was when I started the Emsam by itself, too. I don't recall the low blood pressure being this big of an effect with the oral version- there's something about the oral version being more stimulating. But yes, I've been instructed to be super cautious with adderall, and before, with the ritalin. Especially with adderall- for the first couple weeks I was instructed to check my blood pressure both lying down and standing up in the morning, then about three hours after taking the adderall (because that's when it supposedly is at highest level in the body), and then at the end of the day. I had to show off my numbers so he'd feel ok that I wasn't in danger. I'm so sick of that blood pressure reader I could throw it out the window!
>
> By the way, I was reading up about use of stimulants as antidepressents, and it seems that dexedrine is most associated with an anti-depressent effect (but it's hard to get a prescription). I am completely convinced that adderall is really giving me a mood boost in addition to its other benefits. Dexedrine is a component of adderall. The second expert, a researcher I consulted with per my doctor's suggestion, says he's observed that Emsam and Adderall appear to work synergistically. A clinical observation and hunch- not a study. (But that's why I was switched over from ritalin.) Neither doctor thought tolerance would be much of an issue with adderall or other short-acting stimulant if dose was kept as low as possible, and if not taken late in the day. The theory is it then gets a chance to wash out on a daily basis, and the brain gets lots of recovery time at night.
>
> I hope I answered everything you were wondering. Good luck, Liliths!
>
> Laima
>
>
>
>
> > Hi Liama,
> >
> > would you know the dose that one can take EMSAM on without having the dietary restrictions and in your opinion, would this dose be efficacious? I remember the restrictions of old being absolute and difficult in that I am a vegetarian.
> >
> > what are the benefits of the EMSAM patch over oral selegeline?
> >
> > If I may ask, what is your current combination and dosages of each?
> >
> > I am looking to make a major change in my meds. It has been initated by forces outside me and and I'm probably going to being forced off the only one that still works. But I haven't felt the wellbutrin or buspar were doing much for me these days, though when I went to my pdoc about making changes, he told me it wasn't the meds, I just needed more exercise and structure in my life. Oh Duh! If I could've been doing those things, I wouldn't have been asking him to change meds to begin with. But I ended up agreeing it was ALL my fault and not his laziness!
> >
> > indeed! so I am most likely going to need a new pdoc anyway. I'd honestly like to go off as many meds as possible but I think I also need to be realistic
> >
> > the only other question I have is whether there's weight gain associated with EMSAM? I had a real backlash weight problem after a number of successful months on nardil, which caused me to have to stop the drug. But I also did have a lot of unpleasant side effects. Passing out from low blood pressure as well as an inability to urinate... ended up on medication to help the side effect and that's not something I'd be willing to do again
> >
> > But the nardil really did help, if only for a while... if EMSAM doesn't carry weight gain and I could eat most of my food, it seems to be a pretty good candidate along with my focalin XR and klonopin.
> >
> > And I could also consider going back on Concerta, which I used for years. I only changed when my insurance threatened to stop covering it. Then I guess when they realized people were just switching to focalin (which was more expensive LOL), it appeared back on my formulary. I'm thinking Concerta might be more gentle with the EMSAM... but what do I know?
> >
> > sorry for posing so many questions. You seem to be the one person on a combo that 'might' work for me as well.
> >
> > thanks for your help.
> >
> > namaste,
> > lilith
> >
> > > Hi Liliths,
> > >
> > > You sound like you may indeed be a good candidate for a stimulant-Emsam combo, like me! I hope your doctor is ok about it. Mine is, but he also teaches pharmacology at a major medical school, so he's comfortable with "unconventional". He did write me a note to take to the pharmacy the first time, saying it's ok, because he said they might balk. Now the pharmacy is used to me, and there's no questioning. I was using ritalin with Emsam for a long time, until I consulted with a super-expert (for second opinion), and he said that in his observation, many people tended to particularly respond to an Emsam/adderall combo. I was switched immediately after, and I think it's true, at least for me. I haven't had any weight gain at all from Emsam. Are you using it now, or looking to use it in the future?
> > >
> > > I figured you'd know about mixing MAOIs and other meds as most people around here do, but with the dangers being what they are, and here I am blathering on about the wonders of an unconventional drug combo- I thought I'd bring it up just to be safe. Never know who's reading and what ideas pop into people's minds. Thanks for understanding :)
> > >
> > > Anyway, good luck!
> > >
> > > Laima
> >
> >
>
>
poster:liliths
thread:719417
URL: http://www.dr-bob.org/babble/20070107/msgs/720430.html