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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by crabwalk on July 24, 2006, at 10:39:45
thoughts? i'm on 1/2 a patch now, I think less is more for me since a full patch felt way too powerful...
Posted by SLS on July 24, 2006, at 11:04:36
In reply to anybody tried 1/4 patch of EMSAM?, posted by crabwalk on July 24, 2006, at 10:39:45
> thoughts? i'm on 1/2 a patch now, I think less is more for me since a full patch felt way too powerful...
I get the impression that there are two components to the psychotropic effects of this drug. One is stimulatory, the other is antidepressant. For some people, the stimulatory effect is a bonus and appears almost immediately. It affords them more mental and physical energy. However, for others, it produces problems like irritability, restlessness, insomnia, etc. The antidepressant effect does not appear for some weeks later. Therefore, one must endure these adverse effects in the interim or until they dissipate or until you treat them with a short-term course of an anxiolytic. This is a scenario not unlike what occurs occasionally with SSRIs. Having reduced the dosage to avoid the psychostimulant effects, you might also be precluding the antidepressant effects. That being said, there is still so little clinical experience with this drug to use as a guideline. For all I know, you might be doing exactly the right thing!
- Scott
Posted by Phillipa on July 24, 2006, at 11:32:00
In reply to Re: anybody tried 1/4 patch of EMSAM?, posted by SLS on July 24, 2006, at 11:04:36
Some swear by cutting the patch or taking it off at night. Robert david is the expert in EMSAM . Do you have his e-mail I do. I'll send him a quick one. he's now off klonopin too. And very happy. Love Phillipa ps not to take anything away from you Scott you're our med expert
Posted by RobertDavid on July 24, 2006, at 15:30:35
In reply to Re: anybody tried 1/4 patch of EMSAM? » SLS, posted by Phillipa on July 24, 2006, at 11:32:00
Just like other medications you need to fine tune the dose up or down till it works best for you. The only way to do that with EMSAM is by cutting the patch. I see no issue cutting it in half, quarters or even smaller if necessary. Just try to cut it so that each new cut patch is the same size.
Jan, I am still taking klonopin, a little less, but it's the combo that is working so well for me FYI. That and daily cardio via treadmill... Rob
Posted by SLS on July 24, 2006, at 16:30:06
In reply to Re: anybody tried 1/4 patch of EMSAM?, posted by RobertDavid on July 24, 2006, at 15:30:35
> Just like other medications you need to fine tune the dose up or down till it works best for you. The only way to do that with EMSAM is by cutting the patch. I see no issue cutting it in half, quarters or even smaller if necessary. Just try to cut it so that each new cut patch is the same size.
What dosage are you currently at?Are you removing the patch at night?
- Scott
Posted by RobertDavid on July 24, 2006, at 17:12:22
In reply to Re: anybody tried 1/4 patch of EMSAM? » RobertDavid, posted by SLS on July 24, 2006, at 16:30:06
> > Just like other medications you need to fine tune the dose up or down till it works best for you. The only way to do that with EMSAM is by cutting the patch. I see no issue cutting it in half, quarters or even smaller if necessary. Just try to cut it so that each new cut patch is the same size.
>
>
> What dosage are you currently at?
>
> Are you removing the patch at night?
>
>
> - Scott
>I cut the 20mg patch in half and take it off at bedtime, but keep in mind I take 1.75mgs klonopin with it. EMSAM just helps my mood, energy and lifts the mental fog I used to have. Klonopin takes care of the anxiety which is my primary disorter...... Rob
Posted by SLS on July 24, 2006, at 17:47:07
In reply to Re: anybody tried 1/4 patch of EMSAM? » SLS, posted by RobertDavid on July 24, 2006, at 17:12:22
> > > Just like other medications you need to fine tune the dose up or down till it works best for you. The only way to do that with EMSAM is by cutting the patch. I see no issue cutting it in half, quarters or even smaller if necessary. Just try to cut it so that each new cut patch is the same size.
> >
> >
> > What dosage are you currently at?
> >
> > Are you removing the patch at night?
> >
> >
> > - Scott
> >
>
> I cut the 20mg patch in half and take it off at bedtime, but keep in mind I take 1.75mgs klonopin with it. EMSAM just helps my mood, energy and lifts the mental fog I used to have. Klonopin takes care of the anxiety which is my primary disorter...... Rob
Hi Rob.Thanks for taking the time to respond.
How many days into treatment with Emsam did you feel an improvement?
- Scott
Posted by RobertDavid on July 24, 2006, at 18:17:34
In reply to Re: anybody tried 1/4 patch of EMSAM? » RobertDavid, posted by SLS on July 24, 2006, at 17:47:07
I felt an engergy boost within days. I gradually felt better over the next 6 weeks. I could tell it was helping very quickly especially compared to my SSRI trials....
Posted by Phillipa on July 24, 2006, at 19:30:54
In reply to Re: anybody tried 1/4 patch of EMSAM? » SLS, posted by RobertDavid on July 24, 2006, at 18:17:34
Rob thanks for replying to the Thread. Love Jan
Posted by Jost on July 29, 2006, at 13:48:24
In reply to Re: anybody tried 1/4 patch of EMSAM? » RobertDavid, posted by Phillipa on July 24, 2006, at 19:30:54
It almost looks like the packaging of the patch was designed for potential cutting.
There are notches on both sides of the external paper within which the patch is stored, that fit together so you can be sure you're getting half. There is also a pair of notches in the other side, which you can fold. To be absolutely more confident you could cut small notches on the sides opposite the last set of notches.
This will make sense if you look at an individual patch. There are four small notches opposite one another on two sides of the paper container. These are on the sides, and on the top and bottom right. These match up. If you fold it at the notches, the two other notches fit, but to see the fit, you need to cut through where they fit together to see it clearly Then you can see the quarters. (Sorry that this description isn't precise. I can try again later, if it's not cleear what I mean.)
Also, the perforation in the sticky side of the actual patch (as opposed to the outer container) is exactly 1/3rd of the whole patch, so if you cut that off you get 2/3rds/1/3rd, or, you can get three 1/3rd pieces of equal size (I did this this am, with the 12 mg patch). This is a little harder, but not much.
Jost
This is the end of the thread.
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