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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by RobertDavid on May 24, 2006, at 19:23:06
I know there is quite a few people here that have started taking EMSAM and was wondering who is having a positive response.
How long have you been on it, what is your diagnosis and what other meds are you currently taking? What do you like and what side effects don't you like?
I have SAD, GAD and mild depression. I'm taking EMSAM with 2mgs klonopin (at bedtime). I'm not sure how much EMSAM has helped with the anxiety as klonopin has always worked great for that, but EMSAM has given me mental clarity, improved my mood and I have more energy. The only negative for me is I seem to stay mentally alert when I should be sleeping. I have been taking the patch off at night (per my doctors suggestion) which seems to help with sleeping.
Anyway, I'm sure there are lots of people who are considering using that would like to hear your results. I would like to hear as well. Some of you that started EMSAM weeks ago haven't posted in a while and perhaps that's because your doing well or? Thanks Rob
Posted by Phillipa on May 24, 2006, at 20:24:26
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
My doc ended up not prescribing it. I want to know who is doing well too. Can't find another pdoc. Love Phillipa
Posted by aabag on May 24, 2006, at 20:45:10
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
4 weeks now w/ 6mg/20cm2 EMSAM and doing quite well. Almost across the board, life has improved, including motivation, mood overall more euthymic, and a tendency to view slights with less sensitivity. I have noticed that I'm slightly more irritable, but even this is not a uniformly bad thing , in that you're not entirely a push-over due to amotivation. Another thing, more sociability is noted, i.e. talking w/ people who I would have considered "out of my league" is starting to happen. Overall, I probably could be happier, but not that much.
Posted by Jost on May 24, 2006, at 21:29:46
In reply to Re: Who's having luck with EMSAM?, posted by aabag on May 24, 2006, at 20:45:10
This is my fifth day. Can't say I know yet exactly what I think. It isn't a negative, and could be helping. I've had some challenging days, and I handled things better than usual. I'd have to say it was sufficiently better than my usual best that it could be the Emsam.
I can't be definitive at all, however--my ability to handle stress is highly variable.
No bad side effects, except the patch is a a tiny bit uncomfortable at moments. No problem.
Jost
Posted by cecilia on May 25, 2006, at 5:00:37
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
I'm on day 15-no effects that I can see except chronic insomnia seems worse, though at least I'm not waking up every hour like with Marplan. Maybe more headaches, and dry eyes. Feeling very stressed, but I think that's life issues, not med. Cecilia
Posted by Incubusfan on May 25, 2006, at 9:12:59
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
On my sixth day now, so far I haven't noticed anything besides having vivid dreams every night. No problems with sleeping, but then again I can sleep anywhere or anytime I want to :)
I won't be making judgements about EMSAM's effectiveness on me for at least 6 weeks.
Posted by RobertDavid on May 25, 2006, at 12:32:10
In reply to Emsam: No luck so far, posted by cecilia on May 25, 2006, at 5:00:37
> I'm on day 15-no effects that I can see except chronic insomnia seems worse, though at least I'm not waking up every hour like with Marplan. Maybe more headaches, and dry eyes. Feeling very stressed, but I think that's life issues, not med. Cecilia
Cecilia:
I know that when I don't sleep well I don't feel good no matter what medication I'm taking. You might consider taking the patch off at night and putting back on in the morning. That was a suggestion my doctor gave me which is helping me sleep and felt good after just one night. Just a thought. Rob
Posted by sweetnlow on May 25, 2006, at 14:55:31
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
*** I'm on day 10 and I really like EMSAM. I'm more motivated and more social. Not a lot, but just enough. I have mild depression and dysthymia, i.e., I get uninterested a lot but not profoundly depressed. Med history: I can't SSRIs because they make me paranoid and anxious, and Parnate made me sleepy (for all 12 weeks) and marplan did nothing; I was a poster-boy for nardil, though-- loved it but I ended up gaining too much weight on it so I quit it. The only other drug I take is klonopin, and I rarely take more than 1 mg a week, if that. Years ago I managed to get cross-addicted to valium and liquor, but I quit the valium and liquor hasn;t been a problem ever since I took a couple of years of nardil (apparently it just about cured me of my overdrinking). Hope this helps. Good luck.***
> I know there is quite a few people here that have started taking EMSAM and was wondering who is having a positive response.
>
> How long have you been on it, what is your diagnosis and what other meds are you currently taking? What do you like and what side effects don't you like?
>
> I have SAD, GAD and mild depression. I'm taking EMSAM with 2mgs klonopin (at bedtime). I'm not sure how much EMSAM has helped with the anxiety as klonopin has always worked great for that, but EMSAM has given me mental clarity, improved my mood and I have more energy. The only negative for me is I seem to stay mentally alert when I should be sleeping. I have been taking the patch off at night (per my doctors suggestion) which seems to help with sleeping.
>
> Anyway, I'm sure there are lots of people who are considering using that would like to hear your results. I would like to hear as well. Some of you that started EMSAM weeks ago haven't posted in a while and perhaps that's because your doing well or? Thanks Rob
Posted by RobertDavid on May 25, 2006, at 15:41:35
In reply to Re: Who's having luck with EMSAM?, posted by sweetnlow on May 25, 2006, at 14:55:31
Years ago I managed to get cross-addicted to valium and liquor, but I quit the valium and liquor hasn;t been a problem ever since I took a couple of years of nardil (apparently it just about cured me of my overdrinking). Hope this helps. Good luck.***
>I'm not sure if it's appropriate to address this question on this board, perhaps you could babble mail me your response. I was wondering about your comment regarding cross addiction with alcohol and valium. Did you feel valium created the problem? Will you elaborate? Thanks Rob
Posted by Jakeman on May 25, 2006, at 20:15:11
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
Just started today. Will report back.
warm regards, Jake
Posted by ZeitGuest on May 26, 2006, at 1:14:49
In reply to Re: Who's having luck with EMSAM?, posted by Jakeman on May 25, 2006, at 20:15:11
I'm on day 21 of EMSAM. So far, no beneficial effects for my social anxiety and atypical depression. The only side effect I'm experiencing is increased irritability (some days moreso than others). No insomnia problems, but maybe that's because I've been a major caffeine (ab)user for years and my threshold for stimulants is pretty high. No negative sexual side effects to report, either.
I'll keep "patching" for at least six weeks, and report back if anything begins to change.
Posted by bulldog2 on May 26, 2006, at 7:59:32
In reply to Re: Who's having luck with EMSAM?, posted by ZeitGuest on May 26, 2006, at 1:14:49
This is my 12th day on emsam. The last couple of days i've felt more motivated and enthusiatic about things. I guess that's a good sign. Let's see if this continues.
Posted by Breeze on May 26, 2006, at 13:00:48
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
I've been on Emsam now for 7 days. I have noticed a big difference using the patch. I am more alert, more involved, and have lots more energy. The only down side I've seen is more irritability and a rise in my anxiety level. I've been taking Xanax (.25 3/day) for years and since taking Emsam I seem to have break through anxiety. I'm hoping this will subside if I take Emsam for a longer period.
I have GAD and SAD with minor depression. Was on Nardil for 20+ years and felt great. Nardil stopped working for me a few years ago when the formula changed. Been trying various combinations of drugs, i.e., Zoloft, Lexapro, Effexor. None has come close to Emsam. They all made me feel drugged and apathetic.
Hope Emsam continues to work for me and I can get my anxiety level back in control.
Posted by RobertDavid on May 26, 2006, at 14:48:56
In reply to Re: Who's having luck with EMSAM?, posted by Breeze on May 26, 2006, at 13:00:48
> I've been on Emsam now for 7 days. I have noticed a big difference using the patch. I am more alert, more involved, and have lots more energy. The only down side I've seen is more irritability and a rise in my anxiety level. I've been taking Xanax (.25 3/day) for years and since taking Emsam I seem to have break through anxiety. I'm hoping this will subside if I take Emsam for a longer period.
>
> I have GAD and SAD with minor depression. Was on Nardil for 20+ years and felt great. Nardil stopped working for me a few years ago when the formula changed. Been trying various combinations of drugs, i.e., Zoloft, Lexapro, Effexor. None has come close to Emsam. They all made me feel drugged and apathetic.
>
> Hope Emsam continues to work for me and I can get my anxiety level back in control.
>
>
You're response to EMSAM and diagnosis is very similar to mine. Have you thought about or tried going to a longer acting benzo like klonopin vs xanax? Just a thought, klonopin does the trick for me, but you just have to find the right dose to be effective. Good luck. Rob
Posted by sweetnlow on May 26, 2006, at 17:02:54
In reply to Re: Who's having luck with EMSAM? » sweetnlow, posted by RobertDavid on May 25, 2006, at 15:41:35
Robert- I wrote you a lengthy piece on this, but when I went to transmit it via [whatever that is where it just goes to you-- Babblemail?] I wasn't registered, and when I registered, the system deleted my entire piece. So-- hang in there and I will write over the weekend, a it appears we have much in common. Sweetnlow
> Years ago I managed to get cross-addicted to valium and liquor, but I quit the valium and liquor hasn;t been a problem ever since I took a couple of years of nardil (apparently it just about cured me of my overdrinking). Hope this helps. Good luck.***
> >
>
> I'm not sure if it's appropriate to address this question on this board, perhaps you could babble mail me your response. I was wondering about your comment regarding cross addiction with alcohol and valium. Did you feel valium created the problem? Will you elaborate? Thanks Rob
Posted by Jakeman on May 26, 2006, at 20:10:10
In reply to Re: Who's having luck with EMSAM?, posted by Breeze on May 26, 2006, at 13:00:48
I've only been on Emsam for two days. Could be a placebo effect, but I feel slightly more motivated to exercise. I rode my bike to work today for the first time in three months.
warm regards, Jake
> I've been on Emsam now for 7 days. I have noticed a big difference using the patch. I am more alert, more involved, and have lots more energy. The only down side I've seen is more irritability and a rise in my anxiety level. I've been taking Xanax (.25 3/day) for years and since taking Emsam I seem to have break through anxiety. I'm hoping this will subside if I take Emsam for a longer period.
>
> I have GAD and SAD with minor depression. Was on Nardil for 20+ years and felt great. Nardil stopped working for me a few years ago when the formula changed. Been trying various combinations of drugs, i.e., Zoloft, Lexapro, Effexor. None has come close to Emsam. They all made me feel drugged and apathetic.
>
> Hope Emsam continues to work for me and I can get my anxiety level back in control.
>
>
Posted by Jakeman on May 26, 2006, at 23:38:11
In reply to Re: Who's having luck with EMSAM?, posted by bulldog2 on May 26, 2006, at 7:59:32
I've been reseaching some, thought I'd pass this along:
Neuroprotective actions of Selegiline in inhibiting 1-methyl, 4-phenyl, pyridinium ion (MPP+)-induced apoptosis in SK-N-SH neurons.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14724376(-)-Deprenyl, a selective MAO-B inhibitor, with apoptotic and anti-apoptotic properties.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14697898warm regards, Jake
Posted by Jakeman on May 26, 2006, at 23:50:00
In reply to Re: Who's having luck with EMSAM? some studies, posted by Jakeman on May 26, 2006, at 23:38:11
PS, apoptosis means death of brain cells, in this context.
Posted by Donna Louise on May 27, 2006, at 6:44:24
In reply to Who's having luck with EMSAM?, posted by RobertDavid on May 24, 2006, at 19:23:06
> I know there is quite a few people here that have started taking EMSAM and was wondering who is having a positive response.
>
> How long have you been on it, what is your diagnosis and what other meds are you currently taking? What do you like and what side effects don't you like?
>
> I have SAD, GAD and mild depression. I'm taking EMSAM with 2mgs klonopin (at bedtime). I'm not sure how much EMSAM has helped with the anxiety as klonopin has always worked great for that, but EMSAM has given me mental clarity, improved my mood and I have more energy. The only negative for me is I seem to stay mentally alert when I should be sleeping. I have been taking the patch off at night (per my doctors suggestion) which seems to help with sleeping.
>
> Anyway, I'm sure there are lots of people who are considering using that would like to hear your results. I would like to hear as well. Some of you that started EMSAM weeks ago haven't posted in a while and perhaps that's because your doing well or? Thanks RobHey Rob, and all others, you haven't heard from me in awhile as I was in Tenn. with one of my horses on vacation and had no computer access. I guess you could say that since I was able to do that, I am doing pretty good! Tomorrow will begin my fifth week, I think...yes, fifth week, and I feel better than I have in a long long time. I am still me however, I have mood swings and get irritable and agitated but that is not the drug, it is much worse if I am unmedicated. And as you know Rob, the klonopin is helping me with that. I am still working on the dose and timing with the k but overall, I really can't complain. I have no side effects with the patch, no rash or insomnia (I have always been a good sleeper, sometimes way too good). I still take 300-400mg provigil but as I said elsewhere, that is more for mood enhancement and social motivation that for help staying awake. So far so good for me.
Donna
Posted by crabwalk on May 27, 2006, at 11:44:25
In reply to Re: Who's having luck with EMSAM? » RobertDavid, posted by Donna Louise on May 27, 2006, at 6:44:24
I've had a bit of a roller coaster ride so far on emsam. My situation is unique: I decided to try emsam to see if it would reverse the damage that ssris did to me. I quit them over a year ago and the sexual numbness and dysfunction that they caused never went away. This along with some traumatically bad reactions to other drugs that I tried to reverse the problem (buspar, tianeptine) has really caused some damage to my psyche. So far I haven't had the benefit I had hoped for, but I will wait another couple weeks at least.
At first, emsam made me incredibly anxious, then incredibly depressed and fatigued, very intense for about 2 weeks. Now it's hard to say what it's doing. The biggest problem for me is that I couldn't sleep at all before, and still can't now, i average maybe 4 hours a night with ambien. If I could sleep I would probably be feeling a lot better. Unfortunately I don't think I will ever consider myself happy unless I get my ability to feel emotions and sexual pleasure back the way they were before ssris killed them. That is THE confounding factor in my battle, and no one can really say when/if/how that factor can be addressed, so I am and have been indefinitely stuck like this.
Posted by RobertDavid on May 27, 2006, at 13:13:09
In reply to Re: Who's having luck with EMSAM? » RobertDavid, posted by Donna Louise on May 27, 2006, at 6:44:24
> Hey Rob, and all others, you haven't heard from me in awhile as I was in Tenn. with one of my horses on vacation and had no computer access. I guess you could say that since I was able to do that, I am doing pretty good! Tomorrow will begin my fifth week, I think...yes, fifth week, and I feel better than I have in a long long time. I am still me however, I have mood swings and get irritable and agitated but that is not the drug, it is much worse if I am unmedicated. And as you know Rob, the klonopin is helping me with that. I am still working on the dose and timing with the k but overall, I really can't complain. I have no side effects with the patch, no rash or insomnia (I have always been a good sleeper, sometimes way too good). I still take 300-400mg provigil but as I said elsewhere, that is more for mood enhancement and social motivation that for help staying awake. So far so good for me.
>
> Donna
>
Donna:Glad to hear you're doing better. I don't remember you mentioning before your were still taking 300-400mgs of Provigil. You indicated you're taking provigil for mood enhancement and social motivation which is just what EMSAM seems to help, perhaps you don't need as much provigil since adding EMSAM, both are activating.
Maybe the going up on klonopin (which you're doing) and coming down on provigil would improve your agitation.
I know everyone is different. When I took provigil I maxed out at about 50mgs (which is a low dose) and even that really jacked me up. When I tried more I was very agitated. I wonder now that you've added another stimulating medicine (EMSAM) if you need that high of a dose.
The good thing about provigil, is you'll know right away if it helps and if not, you can go right back up to the dose you like. Both klonopin and provigil are good that way as unlike SSRI's and other meds including EMSAM it doesn't take a month or so to see how you're going to do. Just a thought. Glad to hear you're improved! Rob
Posted by Donna Louise on May 27, 2006, at 18:05:54
In reply to Re: Who's having luck with EMSAM? » Donna Louise, posted by RobertDavid on May 27, 2006, at 13:13:09
> > Hey Rob, and all others, you haven't heard from me in awhile as I was in Tenn. with one of my horses on vacation and had no computer access. I guess you could say that since I was able to do that, I am doing pretty good! Tomorrow will begin my fifth week, I think...yes, fifth week, and I feel better than I have in a long long time. I am still me however, I have mood swings and get irritable and agitated but that is not the drug, it is much worse if I am unmedicated. And as you know Rob, the klonopin is helping me with that. I am still working on the dose and timing with the k but overall, I really can't complain. I have no side effects with the patch, no rash or insomnia (I have always been a good sleeper, sometimes way too good). I still take 300-400mg provigil but as I said elsewhere, that is more for mood enhancement and social motivation that for help staying awake. So far so good for me.
> >
> > Donna
> >
>
>
> Donna:
>
> Glad to hear you're doing better. I don't remember you mentioning before your were still taking 300-400mgs of Provigil. You indicated you're taking provigil for mood enhancement and social motivation which is just what EMSAM seems to help, perhaps you don't need as much provigil since adding EMSAM, both are activating.
>
> Maybe the going up on klonopin (which you're doing) and coming down on provigil would improve your agitation.
>
> I know everyone is different. When I took provigil I maxed out at about 50mgs (which is a low dose) and even that really jacked me up. When I tried more I was very agitated. I wonder now that you've added another stimulating medicine (EMSAM) if you need that high of a dose.
>
> The good thing about provigil, is you'll know right away if it helps and if not, you can go right back up to the dose you like. Both klonopin and provigil are good that way as unlike SSRI's and other meds including EMSAM it doesn't take a month or so to see how you're going to do. Just a thought. Glad to hear you're improved! Rob
>Hey Rob, i had hoped that I could eliminate or reduce the provigil and have given that a try. And I noticed the difference. I hope to try again now that I have been on EMSAM longer, maybe in another month or so. Or maybe I need a higher dose of EMSAM. I have just completed only 4 weeks so I don't know yet.
Like Crabwalk mentions, I am afraid I have some permanent damage from the SRI's, one of which being so sleepy all the time. That began for me with the zoloft. I have not had a return of sexual function either, maybe that is lost for good too. I had heard that selegiline could be sexually enhancing and it has not been for me. It hasn't made it worse but it is not really much better either. There could be other factors at work since I am 52 but still....
Posted by jetcity10 on June 1, 2006, at 11:46:38
In reply to Re: Who's having luck with EMSAM?, posted by crabwalk on May 27, 2006, at 11:44:25
I have a history of major depression as well as anxiety and have struggled with significant suicidal thoughts most of my life. I had tried just about everything but the MAOIs and had no real positive response and a lot of nasty side effects. (Cylert mixed with another AD had been the "best" response but even that was weak and not worth it).
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. Minor side effects include some postural hypotension, mild GI disruptions, snd skin rashes easily taken care of with cortizone. Another positive is that I have started working out, which I never had the energy to do before.
I am still on the lowest dose. I saw my pdoc after 3 1/2 weeks, and due to the reluctance on both of our parts to consider possible dietary restrictions we decided to stay at the lowest dose for now. I had mostly given up on ADs and I have been off of everything but Klonipin (which allowed me at least 4-5 hours of decent sleep a night) for years and just struggled with the depression.
Like I have said, it has been worth it. I have never had as noticible a difference. I still get suicidal, but it doesn't last as long and I am thinking much more rationally about it, as well as the rest of my life. I would say my biggest problem right now is figuring out how to deal with feeling better. It has been longer than I can remember since I have felt even this good. It seems like a strange problem, but it has been a significant challenge thus far. Still worth it though.
Posted by Jakeman on June 3, 2006, at 22:15:22
In reply to Re: Who's having luck with EMSAM?, posted by jetcity10 on June 1, 2006, at 11:46:38
Jetcity,
I've been on it about 10 days. Overall it has been worth it, time will tell. I've had mostly good days, sleep is an issue that I'm working on but I don't consider in insolveable at this point. It doesn't make me emotionally numb which I appreciate. Cognitive abilities and motivations have improved, but nothing real dramatic overall.
Thanks for your feedback, please keep us posted.warm regards, Jake
> I have a history of major depression as well as anxiety and have struggled with significant suicidal thoughts most of my life. I had tried just about everything but the MAOIs and had no real positive response and a lot of nasty side effects. (Cylert mixed with another AD had been the "best" response but even that was weak and not worth it).
>
> 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. Minor side effects include some postural hypotension, mild GI disruptions, snd skin rashes easily taken care of with cortizone. Another positive is that I have started working out, which I never had the energy to do before.
>
> I am still on the lowest dose. I saw my pdoc after 3 1/2 weeks, and due to the reluctance on both of our parts to consider possible dietary restrictions we decided to stay at the lowest dose for now. I had mostly given up on ADs and I have been off of everything but Klonipin (which allowed me at least 4-5 hours of decent sleep a night) for years and just struggled with the depression.
>
> Like I have said, it has been worth it. I have never had as noticible a difference. I still get suicidal, but it doesn't last as long and I am thinking much more rationally about it, as well as the rest of my life. I would say my biggest problem right now is figuring out how to deal with feeling better. It has been longer than I can remember since I have felt even this good. It seems like a strange problem, but it has been a significant challenge thus far. Still worth it though.
This is the end of the thread.
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