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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Jakeman on May 22, 2006, at 19:28:57
I know nothing about the half life of this drug and the transdermal method of delivery.
I wonder how one might arrange peak effects to occur in daytime. Is it feasible to put on the patch first thing in morning then take it off around 4 or 5 pm? Would that help with any night-time agitation? Any comments appreciated.
warm regards, Jake
Posted by Phillipa on May 22, 2006, at 21:45:58
In reply to Emsam and insomnia, posted by Jakeman on May 22, 2006, at 19:28:57
Jake some have done this. And make sure you have a benzo. Love Phillipa
Posted by RobertDavid on May 22, 2006, at 23:24:07
In reply to Emsam and insomnia, posted by Jakeman on May 22, 2006, at 19:28:57
> I know nothing about the half life of this drug and the transdermal method of delivery.
>
> I wonder how one might arrange peak effects to occur in daytime. Is it feasible to put on the patch first thing in morning then take it off around 4 or 5 pm? Would that help with any night-time agitation? Any comments appreciated.
>
> warm regards, JakeJake:
I have always suffered from insomnia. EMSAM is activating and hasn't improved my sleeping.
But in looking for ways to improve my sleep my doctor recomended I take off the patch before bedtime and put it back on in the morning which did help. Your basically wearing it 16 hours and off 8. Selegiline has a short half life so you can get away with it.
I had suspected that I was getting more selegiline than I needed. I mean I really felt good, noticable increase in energy all positives, but with the 24 hour delivery even at the 20mg dose it was continuing strong through the night. And since the increase in energy was so noticable I wished I had an option to try taking a slightly lower dose.
So I contacted a reasercher from the EMSAM studies and discussed if the patch could be cut (you can read from my above post about it if you like) and though the packaging says do not cut it, he indicated you can without issue, in fact that's what they did with test animals.
Anyway, I cut it in half this morning and felt very good today. I'm planning on wearing my new "10mg patch" 24/7 and hope I sleep better while getting the dose necessary for me to get the benefits I want. We'll see.
I'm not sure what your primary disorter is, but mine is SAD and GAD with mild depression. I'm hoping that my new smaller dose will be enough to continue to keep my mood up, give me the energy I like and to offset the mental fog I get from klonopin (which treats my anxiety). I would suspect those with major depression will need higher doses, 10mgs would not be enough. In the studies 7% of the patients reported insomnia.
Anyway, a couple options for you to think about. Otherwise you could always take something with it until your body hopefully adjusts to it like Lunesta or even Seroquel (which will probably knock you out).
Good luck
Rob
Posted by Jakeman on May 23, 2006, at 19:15:33
In reply to Re: Emsam and insomnia, posted by RobertDavid on May 22, 2006, at 23:24:07
Rob.
Thanks for your thoughtful reply and all your previous contributions to this discussion. I'm real interested to see how you do on the lowered dose. I'm dealing with agitated depression, insomnia, social anxiety. I don't see Emsam as an end-all. Most likely it will have to be combined with something else.. benzo, mood stabilizer or both. I like the fact that selegiline has been used for many years in the smart drug community. I've taken about every SSRI-SSNRI-tricyclic on the market so I'm running out of choices. Most doctors don't want to deal with me because I'm not an easy fix.
warm regards, Jake
>
>
> I have always suffered from insomnia. EMSAM is activating and hasn't improved my sleeping.
>
> But in looking for ways to improve my sleep my doctor recomended I take off the patch before bedtime and put it back on in the morning which did help. Your basically wearing it 16 hours and off 8. Selegiline has a short half life so you can get away with it.
>
> I had suspected that I was getting more selegiline than I needed. I mean I really felt good, noticable increase in energy all positives, but with the 24 hour delivery even at the 20mg dose it was continuing strong through the night. And since the increase in energy was so noticable I wished I had an option to try taking a slightly lower dose.
>
> So I contacted a reasercher from the EMSAM studies and discussed if the patch could be cut (you can read from my above post about it if you like) and though the packaging says do not cut it, he indicated you can without issue, in fact that's what they did with test animals.
>
> Anyway, I cut it in half this morning and felt very good today. I'm planning on wearing my new "10mg patch" 24/7 and hope I sleep better while getting the dose necessary for me to get the benefits I want. We'll see.
>
> I'm not sure what your primary disorter is, but mine is SAD and GAD with mild depression. I'm hoping that my new smaller dose will be enough to continue to keep my mood up, give me the energy I like and to offset the mental fog I get from klonopin (which treats my anxiety). I would suspect those with major depression will need higher doses, 10mgs would not be enough. In the studies 7% of the patients reported insomnia.
>
> Anyway, a couple options for you to think about. Otherwise you could always take something with it until your body hopefully adjusts to it like Lunesta or even Seroquel (which will probably knock you out).
>
> Good luck
> Rob
Posted by RobertDavid on May 24, 2006, at 16:48:11
In reply to Re: Emsam and insomnia » RobertDavid, posted by Jakeman on May 23, 2006, at 19:15:33
> Rob.
>
> Thanks for your thoughtful reply and all your previous contributions to this discussion. I'm real interested to see how you do on the lowered dose. I'm dealing with agitated depression, insomnia, social anxiety. I don't see Emsam as an end-all. Most likely it will have to be combined with something else.. benzo, mood stabilizer or both. I like the fact that selegiline has been used for many years in the smart drug community. I've taken about every SSRI-SSNRI-tricyclic on the market so I'm running out of choices. Most doctors don't want to deal with me because I'm not an easy fix.
>
> warm regards, Jake
Jake:
I too like the fact the EMSAM is considered a "smart drug" and based on how it's cleared up my head it's indeed that for me. I also agree that it's alone not perfect. Perhaps those that have just major depression will be able to use it as mono therapy and I know that many of them don't have trouble sleeping with it.
I also agree that a blend with a medicine like klonopin will be key in getting relief from anxiety, iritablilty and agitation. It can also help with sleep. I take my full klonopin dose at night (now back to 2mgs - that's what it takes for me to feel my best).
Nothing has been so as effective for my mental alertness and mood as EMSAM. So, as I've stated, I'm playing with ways to find out how to best use it, what dose (cutting it in half) as well as taking it off at night. Too soon for me to say which way I like it the best.
My suggestion to you would be to add klonopin, see how you do with the combo. Slowly go up on the dose until you get anxiety relief and stay there for a while, see how you do. You should know very quickly if it's helping. My opinion is that benzos are one of the best meds for anxiety and some of your other issues. It just may also solve your insomnia issues.
Otherwise you might first just try just taking the patch off at bedtime. When I did I slept much better, woke up, put it back on (I'd put it on as soon as you wake up). My doc said it was okay to do that.
Lastly, I'm still doing well on 10mgs and in fact am going to take it off at bedtime for a while and see how that works. I still feel the good energy surge and elivated mood at 10mgs, but we'll see if that lasts. After this last test with EMSAM I'll make a decision and settle in on how to best use it.
For me, when I don't sleep well it really has a negative effect on how I feel, my anxiety level and mood. So fine tuning the best way to get a good nights sleep is key. Anyway, I'm looking forward to hearing how your doing! Rob
Posted by Iansf on May 25, 2006, at 0:49:55
In reply to Re: Emsam and insomnia » Jakeman, posted by RobertDavid on May 24, 2006, at 16:48:11
When you say you're taking 10mg of Emsam, does that mean one half of the 6mg patch, which would be equivalent to 10mg of oral selegiline? It comes in 6mg, 9mg and 12mg patches.
> > Rob.
> >
> > Thanks for your thoughtful reply and all your previous contributions to this discussion. I'm real interested to see how you do on the lowered dose. I'm dealing with agitated depression, insomnia, social anxiety. I don't see Emsam as an end-all. Most likely it will have to be combined with something else.. benzo, mood stabilizer or both. I like the fact that selegiline has been used for many years in the smart drug community. I've taken about every SSRI-SSNRI-tricyclic on the market so I'm running out of choices. Most doctors don't want to deal with me because I'm not an easy fix.
> >
> > warm regards, Jake
>
>
> Jake:
>
> I too like the fact the EMSAM is considered a "smart drug" and based on how it's cleared up my head it's indeed that for me. I also agree that it's alone not perfect. Perhaps those that have just major depression will be able to use it as mono therapy and I know that many of them don't have trouble sleeping with it.
>
> I also agree that a blend with a medicine like klonopin will be key in getting relief from anxiety, iritablilty and agitation. It can also help with sleep. I take my full klonopin dose at night (now back to 2mgs - that's what it takes for me to feel my best).
>
> Nothing has been so as effective for my mental alertness and mood as EMSAM. So, as I've stated, I'm playing with ways to find out how to best use it, what dose (cutting it in half) as well as taking it off at night. Too soon for me to say which way I like it the best.
>
> My suggestion to you would be to add klonopin, see how you do with the combo. Slowly go up on the dose until you get anxiety relief and stay there for a while, see how you do. You should know very quickly if it's helping. My opinion is that benzos are one of the best meds for anxiety and some of your other issues. It just may also solve your insomnia issues.
>
> Otherwise you might first just try just taking the patch off at bedtime. When I did I slept much better, woke up, put it back on (I'd put it on as soon as you wake up). My doc said it was okay to do that.
>
> Lastly, I'm still doing well on 10mgs and in fact am going to take it off at bedtime for a while and see how that works. I still feel the good energy surge and elivated mood at 10mgs, but we'll see if that lasts. After this last test with EMSAM I'll make a decision and settle in on how to best use it.
>
> For me, when I don't sleep well it really has a negative effect on how I feel, my anxiety level and mood. So fine tuning the best way to get a good nights sleep is key. Anyway, I'm looking forward to hearing how your doing! Rob
>
>
Posted by theo on May 25, 2006, at 12:26:44
In reply to Re: Emsam and insomnia » Jakeman, posted by RobertDavid on May 24, 2006, at 16:48:11
> Otherwise you might first just try just taking the patch off at bedtime. When I did I slept much better, woke up, put it back on (I'd put it on as soon as you wake up). My doc said it was okay to do that.
>
When you take a patch off at bedtime, do you put on a new patch or reuse the old one twice?
Posted by RobertDavid on May 25, 2006, at 13:05:43
In reply to Re: Emsam and insomnia » RobertDavid, posted by theo on May 25, 2006, at 12:26:44
> > Otherwise you might first just try just taking the patch off at bedtime. When I did I slept much better, woke up, put it back on (I'd put it on as soon as you wake up). My doc said it was okay to do that.
> >
> When you take a patch off at bedtime, do you put on a new patch or reuse the old one twice?I take the patch of an hour before I go to bed, throw it away, then put a new one on first thing in the morning. I'm sleeping much better and still feel the benefits I've been getting from it, in fact feel better since I'm sleeping better. Good luck.
Posted by Jakeman on May 25, 2006, at 20:05:20
In reply to Re: Emsam and insomnia » RobertDavid, posted by Jakeman on May 23, 2006, at 19:15:33
Hi Rob,
I went to a new pdoc (physician asst.) today and obtained 10 samples and a prescription for Emsam. I been wearing it today and was pleased about how easy it was to apply and how it's not even noticable.
She had no problem with cutting the patch in half, so that's what I'm doing at least for now since I'm sensitive to activating meds.
I also take Lyrica (50mg) in the afternoon for anxiety, and Restoril at night, usually with .5 mg Klonipin. I may go up on the Klonipin if needed. I feel cautiously hopeful.
Do you still keep the patch on at night?Good luck, Jake
>
> >
> >
> > I have always suffered from insomnia. EMSAM is activating and hasn't improved my sleeping.
> >
> > But in looking for ways to improve my sleep my doctor recomended I take off the patch before bedtime and put it back on in the morning which did help. Your basically wearing it 16 hours and off 8. Selegiline has a short half life so you can get away with it.
> >
> > I had suspected that I was getting more selegiline than I needed. I mean I really felt good, noticable increase in energy all positives, but with the 24 hour delivery even at the 20mg dose it was continuing strong through the night. And since the increase in energy was so noticable I wished I had an option to try taking a slightly lower dose.
> >
> > So I contacted a reasercher from the EMSAM studies and discussed if the patch could be cut (you can read from my above post about it if you like) and though the packaging says do not cut it, he indicated you can without issue, in fact that's what they did with test animals.
> >
> > Anyway, I cut it in half this morning and felt very good today. I'm planning on wearing my new "10mg patch" 24/7 and hope I sleep better while getting the dose necessary for me to get the benefits I want. We'll see.
> >
> > I'm not sure what your primary disorter is, but mine is SAD and GAD with mild depression. I'm hoping that my new smaller dose will be enough to continue to keep my mood up, give me the energy I like and to offset the mental fog I get from klonopin (which treats my anxiety). I would suspect those with major depression will need higher doses, 10mgs would not be enough. In the studies 7% of the patients reported insomnia.
> >
> > Anyway, a couple options for you to think about. Otherwise you could always take something with it until your body hopefully adjusts to it like Lunesta or even Seroquel (which will probably knock you out).
> >
> > Good luck
> > Rob
>
>
Posted by RobertDavid on May 25, 2006, at 21:17:57
In reply to Re: Emsam and insomnia » Jakeman, posted by Jakeman on May 25, 2006, at 20:05:20
> Hi Rob,
>
> I went to a new pdoc (physician asst.) today and obtained 10 samples and a prescription for Emsam. I been wearing it today and was pleased about how easy it was to apply and how it's not even noticable.
>
> She had no problem with cutting the patch in half, so that's what I'm doing at least for now since I'm sensitive to activating meds.
>
> I also take Lyrica (50mg) in the afternoon for anxiety, and Restoril at night, usually with .5 mg Klonipin. I may go up on the Klonipin if needed. I feel cautiously hopeful.
> Do you still keep the patch on at night?
>
> Good luck, Jake
>Right now I'm still doing good taking the patch off at night and am still cutting the patch in half. Should I lose any of the positive effects I'll probably go back up to the 20 mg patch, but still take it off at night. I feel my best when I sleep good no matter what med I'm taking.
Otherwise, if I went back to the 20mg patch and felt I needed to wear it at night I'd probably need to take something to help me sleep. Right now it's fine though. I'm certain that this combo is my answer (klonopin/EMSAM), it's just a matter of fine tuning the dose and application of EMSAM.
I'd recommend you wear it 24/7 and see how you do, particularly at the 10mg dose. You mentioned taking lyrica for anxiety. Have you ever considered going up on klonopin and dropping lyrica? A higher night dose of klonopin should improve your anxiety and help with sleep. Just a thought.
Glad to hear you've started and hopefully you have a lot to look forward to! Rob
Posted by Jakeman on May 25, 2006, at 23:01:16
In reply to Re: Emsam and insomnia » Jakeman, posted by RobertDavid on May 25, 2006, at 21:17:57
Rob,
I went on low dose Lycica at the suggestion of my neuologist/sleep doctor. It seems to ameilorate the depression and anxiety I get in mid-late lafternoon and seems helps with deep sleep. That's my feeling now, I may change my mind later. Trying to find the balance...
warm regards, Jake
> I'd recommend you wear it 24/7 and see how you do, particularly at the 10mg dose. You mentioned taking lyrica for anxiety. Have you ever considered going up on klonopin and dropping lyrica? A higher night dose of klonopin should improve your anxiety and help with sleep. Just a thought.
>
Posted by helpme on July 9, 2006, at 4:29:04
In reply to Re: Emsam and insomnia » Jakeman, posted by Jakeman on May 25, 2006, at 20:05:20
I've wondered about this too- my doc knows the folks who helped develop this product and so I quizzed him: "so, it's an even-release over 24 hours?" "Yes." "What about the amphetemine metabolites and don't they interfere with sleep?" And he sort of got uncomfortable there. It's all about polypharmacy, isn't it? He did say that this wasn't quite such a vexing problem with the pills because they metabolize differently- that is- they are not "continual and even release".
Posted by jealibeanz on July 9, 2006, at 21:15:53
In reply to Re: Emsam and insomnia, posted by helpme on July 9, 2006, at 4:29:04
So he's basically acknowledging that it causes insomnia? Other than that, does he support EMSAM as an effective medication for anxiety/depression?
This is the end of the thread.
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