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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by Phillipa on May 20, 2006, at 12:07:58
At first people were saying EMSAM was the med of all meds. Not people seem to be getting side effects worse than their original symptoms. Would you say EMSAM is not living up to what you thought it would be in the earlier weeks. And is it better for anxiety or depression or the combo of both. Thanks Phillipa
Posted by Maximus on May 20, 2006, at 13:41:06
In reply to Is EMSAM Not The Med People Thought It Was?, posted by Phillipa on May 20, 2006, at 12:07:58
Hi,
I'm not taking Emsam. But Emsam being Selegiline, i would think that it is a good antidepressant with energizing properties. It might be very good for a retarded depression. For Social phobia may be, but for a pure GAD condition without depression, i would say no. While on it, a strong benzo may keep the anxiety at bay.
Posted by Glydin on May 20, 2006, at 14:14:28
In reply to Re: Is EMSAM Not The Med People Thought It Was? » Phillipa, posted by Maximus on May 20, 2006, at 13:41:06
In reality, I don't think ANY med meets folk's expectations in the release and beginning phases of use are. Hype and reality are very different but it doesn't mean a med isn't effective for some - maybe even a great number - of folks.
I don't think alot can be based on the findings of others to decide for ourselves, I just don't. Sharing is great but I really don't like it when I think it's keeping someone from trying something that might turn out to actually help one individual versus another. We are all unique folks - every one of us - and determining how we MIGHT respond without trialing a med might be defeating ourselves before we even start.
You know I'm saying this because I was that kind of person for years. My med phobia was horrible.
Posted by linkadge on May 20, 2006, at 16:46:47
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by Glydin on May 20, 2006, at 14:14:28
I never understood hype, personally. It appears that it is helping some people and not other people, like expected. I don't think it was ever meant to be the med of all meds.
Linkadge
Posted by rvanson on May 20, 2006, at 17:23:44
In reply to Is EMSAM Not The Med People Thought It Was?, posted by Phillipa on May 20, 2006, at 12:07:58
> At first people were saying EMSAM was the med of all meds. Not people seem to be getting side effects worse than their original symptoms. Would you say EMSAM is not living up to what you thought it would be in the earlier weeks. And is it better for anxiety or depression or the combo of both. Thanks Phillipa
No its not all that great, but I didnt expect it to be.Selegiline has been around a long time and some people use it for anti-aging purposes, but its not a particularly great med for depression in oral form and I did not see that a patch would make much diffence execpt that it would cost more then the pills.
In my experience, Aurorix (Mannerix)is a much better A/D med then Emsam, but the FDA will never approve it for use in the USA.
Posted by Phillipa on May 20, 2006, at 18:24:06
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by Glydin on May 20, 2006, at 14:14:28
Glydin how did you get over your med phobia? I just liked the idea of a patch you could take off and the effects would be gone. Almost like taking off a bandaid. Love Phillipa
Posted by UgottaHaveHOPE on May 20, 2006, at 20:29:27
In reply to Re: Is EMSAM Not The Med People Thought It Was? » Glydin, posted by Phillipa on May 20, 2006, at 18:24:06
Even if it doesnt live up to the hype, it is still a major, major, major breakthrough to be able to take a MAOI without having all the dietary restrictions. It's a start in a new direction and ... H-O-P-E.
Posted by RobertDavid on May 20, 2006, at 20:56:17
In reply to Re: Is EMSAM Not The Med People Thought It Was? » Glydin, posted by Phillipa on May 20, 2006, at 18:24:06
I don't think anyone would or should expect that EMSAM is going to be a cure all, a med for everyone, we're all so different. Why do SSRI's work for some and not others? Why does Nardil work for some and Parnate others?
In my opinion it's a good option for those that have failed to respond to other anti depressants (me). And if someone has never tried an MAOI before and wants to, EMSAM would seem to be a good candidate as a first try because if it works you won't have to deal with the food restrictions (20mg dose) and perhaps a lower side effect profile of weight gain and loss of libido.
My guess is that it will work best for those with depression (with or without anxiety) and probably not as well for those specifically with GAD. Perhaps it will be helpful for those with SAD, but it's really to soon to make any conclusions.
For me, it has significantly improved my mood, energy and mental clarity. My anxiety was already controlled to a large extent (though not 100%) with klonopin, but klonopin alone was missing the benefits I am getting from EMSAM. I suspect it's the combo that's the key to my success to this point. The only way I'll be able to determine if it will be effective for my primary disorters (SAD/GAD) as mono therapy is to taper off konopin and see where I land.
But if it turns out to just be a good blend for those like me that find that benzos agrivate depression, zap your energy and mental clarity then it will truly be a fabulous way to get the benefits of a benzo for anxiety and still feel good, with energy, not anxious or depressed. That's what I have been searching for all these years, something to blend with klonopin to treat my depression, but nothing till EMSAM has worked for me.
So my plan is to ultimately try to very slowly go down on klonopin and see how much coverage EMSAM gives me for both SAD & GAD. And though I have sucessfully dropped from 2mgs klonopin to 1.5mgs without increased anxiety I'm going to level off here for several months before dropping again. I'm in no hurry and per my doctors advise I should just enjoy feeling good for a while as I haven't for so long.
So in my opinion, EMSAM will have it's place in a doctors arsenal of treatment options. Just where it lands and who will be the best candidates to try it is just to soon to conclude.
For those that EMSAM and it does the trick, I'm very happy for you, as I wish everyone could have a similar response that that I have had. And for those that flop on it I truly hope you find the answers in your journey to get well as I know first hand how much how much it sucks to be stuck with any of these crappy disorters.
I think it's healthy for those considering trying any med to hear the positive and negative experiences individuals have as long as they have an understanding that everyone is different and responses will be different too. Agian, it's just trial and error with all these meds. Good luck to everyone. Rob
Posted by Glydin on May 20, 2006, at 21:01:06
In reply to Re: Is EMSAM Not The Med People Thought It Was? » Glydin, posted by Phillipa on May 20, 2006, at 18:24:06
> Glydin how did you get over your med phobia?
I think the first thing I did was expect some big difficulties with startup and would do all I could to soldier through. That might sound strange, but it was incredibly helpful for me. Prior to that, the first blush of a feeling of anxiety/panic or any untoward effect I dropped it. Also, I finally got really fed up with my mental status and feeling like there was nothing that could be done and nothing in terms of an AD I could tolerate. Adjusting my Klonopin dose was really important - my doc and I came to the agreement of "whatever it took" to give the med a fighting chance.
I started the med and went into a information blockout as far as researching, reading of other's experiences, etc. I did this not to be reckless, stupid, gullible or not cautious, but I KNEW the impact negative info would have on me. With the current info and the info at the time I started, it would have been VERY easy for me to be convinced to stop the med or never begin it..... the "get out while the getting good" on a head med happened to me when I began Klonopin. Three weeks into beginning, I went a-lookin' on the 'net. Sure enough, no good stuff to be found.... I stopped it due to being scared to pieces. I decompensated very quickly.
I think I had to realize how impacted I was by negative information. My anxiety disorder made that a HUGE factor. I required positive, "you can do it" support to be successful with a med startup.
Some people can be very effective, discerning, and objective when processing information - for some of us, that's difficult when it comes to certain subjects.
Posted by Phillipa on May 20, 2006, at 21:42:16
In reply to Emsam is a scientific breakthrough, posted by UgottaHaveHOPE on May 20, 2006, at 20:29:27
Only on the lowest dose. Love phillipa
Posted by Phillipa on May 20, 2006, at 21:52:47
In reply to Re: » Phillipa, posted by Glydin on May 20, 2006, at 21:01:06
Glydin that's what I knew you'd say. But how come everyone likes klonopin? I wasn't researching or such when I started klonopin and it made me feel suicidal but at the same time my doc was weaning off of xanax and said to take xanax for breakthrough anxiety. Now the question is how do I get this new pdoc to trust me enough to know what's best for me as far as if I switched to klonopin. By the way why does everyone seem to prefer klonopin? Love Phillipa
Posted by Maximus on May 20, 2006, at 22:31:14
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by rvanson on May 20, 2006, at 17:23:44
> In my experience, Aurorix (Mannerix)is a much better A/D med then Emsam, but the FDA will never approve it for use in the USA.
Manerix has been approved here in Canada for about 8 or 9 years. I don't know much about USA politics, but a couple a friends have imported from USA Moclobemide without trouble. Manerix appears to be better tolerated than Selegiline.
Posted by Maximus on May 20, 2006, at 22:45:01
In reply to Re: » Glydin, posted by Phillipa on May 20, 2006, at 21:52:47
> Glydin that's what I knew you'd say. But how come everyone likes klonopin? I wasn't researching or such when I started klonopin and it made me feel suicidal but at the same time my doc was weaning off of xanax and said to take xanax for breakthrough anxiety. Now the question is how do I get this new pdoc to trust me enough to know what's best for me as far as if I switched to klonopin. By the way why does everyone seem to prefer klonopin? Love Phillipa
Hi Philippa
I'm not Glydin. But clonazepam is a stronger and better engineered drug than any benzo out there. At higher dosages (say 6 mgs and up) Klono acts as a mood stabilizer from where you could feel the blaah feeling-i don't care. The key is in the dose. The beauty of Klono is its long half-life of about 24 to 36 hours. Good luck.
Posted by aabag on May 20, 2006, at 23:08:33
In reply to Is EMSAM Not The Med People Thought It Was?, posted by Phillipa on May 20, 2006, at 12:07:58
Is EMSAM the end all be all? No, it cannot be, due to genetic and environmental variability. Is there an a-priori test to determine which compounds or compounds will prove effective anti-depressants for you? Not yet.
I'm closing in our 4 weeks with the 6mg/20cm2 patch and I can say I did believe EMSAM would "work", but couldn't know. I believed this having trialed the combination of DLPA and some oral selegiline to occasional and short-lived success. I realize there are those to which EMSAM was intolerable. To me, Effexor XR was intolerable. Yet, its a multi-billion dollar med. I imagine I might find Haldol intolerable. I don't know, its doesn't match my dx.
As to whether I'm noticing more side effects, the answer is no, I am not. Friends/family have noticed and remarked on my overall increased happiness and less "shrinking-violet", disinterested attitude. And I agree. I wish you all the best, as I empathize with the tormentingly long wait.
Posted by Glydin on May 21, 2006, at 7:02:10
In reply to Re: » Glydin, posted by Phillipa on May 20, 2006, at 21:52:47
> Glydin that's what I knew you'd say. But how come everyone likes klonopin?
~~~ I don't think everyone does.
Again, I think it's a question of what's a good fit. The reference to Klonopin was just used as my personal example of the power and impact of influence. I was just using my K start as an example of how I was doing pretty well on a med until I began second guessing it by being influenced by outside sources. For me, using head meds in general was something I did NOT WANT to do. Finding negative info just fueled my thoughts of how awful they could be. It was an example of how when I looked for something - I found it and could easily discard the positive actual personal results I was getting.
NO med is suited, tolerated, and the best choice for everyone.
Posted by Glydin on May 21, 2006, at 7:21:02
In reply to Re: » Phillipa, posted by Glydin on May 21, 2006, at 7:02:10
Just to add...
It was helpful for me to explore some of the reasons I thought I was med phobic. Sometimes we think we have the obvious answer but for me there were alot of deep rooted reasons, fears concerns, etc.. once uncovered and admitted to myself, helped me. The process gave me alot of insight about myself. I needed to see the forest for the trees, so to speak.
Posted by bulldog2 on May 21, 2006, at 12:31:22
In reply to Is EMSAM Not The Med People Thought It Was?, posted by Phillipa on May 20, 2006, at 12:07:58
I don't think emsam was ever marketed to be the drug of all drugs. It was marketed as another alternative to try when an maoi is indicated for atypical depression. The big selling point was no dietary restrictions at lower doses.
I think it will be more effective for mdd than for anxiety. Selegiline always had a rep of being energizing but many experienced an increase of anxiety on it. I think if one has anxiety a benzo should be used on it. I like klonopin at about 1.5 to 2 milligrams a day. If I find that I would start to need more and more klonopin for anxiety I would stop the emsam.
Personally I don't think it will as effective as nardil or parnate for mdd and social phobia. But those have dietary restrictions and nardil causes weight gain and sexual problems. That's why I chose to try emsam first. But again if one has anxiety a benzo should probably be used with it.
Posted by Phillipa on May 21, 2006, at 13:06:35
In reply to A bit more on med phobia - phillipa, posted by Glydin on May 21, 2006, at 7:21:02
Glydin I know why I'm med phobic cortisone killed my mother in the 60's before they knew what the drug would do she used it for psoriasis a skin condition and she died when I was l7. Love Phillipa
Posted by Glydin on May 21, 2006, at 17:41:05
In reply to Re: Glydin » Glydin, posted by Phillipa on May 21, 2006, at 13:06:35
Are med phobic about all meds?Sometimes the obvious answers we have are just the tip of the iceberg.
I have deep rooted reasons for my fears with psych meds specifically and mine have to do with a traumatic death also but I found out it wasn't the whole story for me.
Posted by Bonnie_CA on May 22, 2006, at 18:07:32
In reply to Re: Glydin » Glydin, posted by Phillipa on May 21, 2006, at 13:06:35
I wasn't the biggest fan of klonopin, it caused me to get very depressed. However, I was taking it because the celexa wasn't working as well anymore. I was thinking about taking it again now that I'm on prozac because it makes me a bit anxious when it peaks in my bloodstream. it didn't make me feel bad otherwise, just depression. Nothing wrong with the xanax, but I've got this klonopin that I could be using. sorry I don't have any input on emsam, as I haven't been on an MAOI.
Posted by darcan on May 28, 2006, at 8:36:31
In reply to Is EMSAM Not The Med People Thought It Was?, posted by Phillipa on May 20, 2006, at 12:07:58
> At first people were saying EMSAM was the med of all meds. Not people seem to be getting side effects worse than their original symptoms. Would you say EMSAM is not living up to what you thought it would be in the earlier weeks. And is it better for anxiety or depression or the combo of both. Thanks Phillipa
I've been searching for an anti-depressant that works for me for nearly 6 years. My doc had suggested MAOI's for nearly 3 years as a possiblity having exhausted virtually all other meds with no success. I had resisted the MAOI's due to the dietary restrictions and quite frankly the dietary instructions available from the two universities where my doc's worked. The lists of restricted foods were just too ambiguous and the risks great. EMSAM promised a way to try the MAOI's while minimizing the risk.
No one ever said it was a wonder drug, and has a published efficacy of 40% (it has helped only 40% of patients trying it). This is actually a bit better than the SSRI's and SSNRI's with a 30% success rate.
I'm on day 15 and it is not working thus far. In fact I am suffering from some of the worse depression and anxiety that I have in 5 years. As with all of these meds you have to give it 4 to 6 weeks so I'm haning in there.
It is not looking good at this time.
Posted by katie san diego on May 28, 2006, at 19:54:55
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by darcan on May 28, 2006, at 8:36:31
i am also taking the emsam for major depression and am now almost done with week 4. like you, i think my anxiety and depression is actually worse than before i started the drug, but my doctor thinks we have to wait it out 5 - 6 weeks before moving on to a higher dose. is this normal? I wish i knew how to read all the emsam threads, but i cant figure out how to sort thru them all here.
a few days after i started, i had a super high energy day - everything seemed great. i wanted to maked plans - do 100 things. then major crash. has anyone else experienced this. my doc thinks this is a "good" sign - like the drug will have a positive effect for me if we just wait it out, but i cant help but believe that weeks of waiting is not a good sign. that feeling worse than before reminds me of other SSRIs where is had bad reactions had eventually had to stop (effexor, wellbutrin)
please, if anyone has anything to offer...
Posted by darcan on May 29, 2006, at 7:34:34
In reply to Re: Is EMSAM Not The Med People Thought It Was? » darcan, posted by katie san diego on May 28, 2006, at 19:54:55
<i am also taking the emsam for major depression and am now almost done with week 4. like you, i think my anxiety and depression is actually worse than before i started the drug, but my doctor thinks we have to wait it out 5 - 6 weeks before moving on to a higher dose. is this normal?
Who knows what normal is, but I've been told that it takes a full 6 weeks before knowing if any drug is effective. My doc had me get off my previous drug (Cymbalta) for three full weeks before starting EMSAM so I don't know if I am having a reaction to EMSAM or just a general lack of antidepressants in my system.
The doc told me that EMSAM actually alters the structure of the brain cells and that the life of a brain cell is 3 weeks therefore the waiting period.
Posted by katie san diego on May 29, 2006, at 10:09:27
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by darcan on May 29, 2006, at 7:34:34
Well, i know for a fact that you dont have to wait 6 weeks to find out if any drug is fully effective. i felt so great on on prozac after only a few weeks. unfortunately, that was 13 years agao, and the prozac seems to have gradually stopped working for me.. increasing dosages gradually over the years and then finally nothing.. no effect at all.
i guess i was spoiled. i wish these doctors knew more about the emsam, or at least made more of an effort to find out how it is affecting the current users.
Posted by jetcity10 on May 30, 2006, at 0:07:42
In reply to Re: Is EMSAM Not The Med People Thought It Was?, posted by katie san diego on May 29, 2006, at 10:09:27
I am about a month and a half into EMSAM. The first few weeks were full of increased anxiety and a major increase in lethal suicidal thinking. Now the suicidal feelings have decreased some and overall I think this is the best response I have ever had to an AD.
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