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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by want2breal on November 21, 2006, at 23:15:58
Hi Friends! I've been depressed since my divorce 4 years ago and can't seem to find anything to FIX it!!!! I have been on Zoloft, Prozac, Paxil, Cymbalta. I've stayed on lexapro the longest, but I still have depression on it. So, My Dr. wants to try me on the ensam patch. What are your experiences on that? He says I only need to be off of Lexapro for 3 days in order to begin it. Does that sound right? And my BIG question is, can I continue to take the Ambien (10 Mg.) while taking the ensam patch???? I sure hope so! He said it would be okay........
I am anxious to get started, as I am a school teacher, and my depression has gotten worse this year. I need some help!!!!!
Thanks for your suggestions and support.
Want2breal!!!!
Posted by tensor on November 22, 2006, at 3:36:57
In reply to Getting ready to start on Ensam patch, can I still, posted by want2breal on November 21, 2006, at 23:15:58
>He says I only need to be off of Lexapro for 3 days in order to begin it. Does that sound right?
Studies have shown that there is no interaction(of clinical significance) between citalopram and selegiline. So I guess that's true for escitalopram too. SSRI and MAOI are usually strictly prohibited together.
>And my BIG question is, can I continue to take the Ambien (10 Mg.)
Yes you can.
/Mattias
Posted by want2breal on November 22, 2006, at 8:43:14
In reply to Re: Getting ready to start on Ensam patch, can I s » want2breal, posted by tensor on November 22, 2006, at 3:36:57
Thank you for your reply. I am going to start the patch tomorrow.
Posted by Jost on November 22, 2006, at 10:16:05
In reply to Re: Getting ready to start on Ensam patch, can I s » want2breal, posted by tensor on November 22, 2006, at 3:36:57
Let us know how it goes. I'm starting again after being off for a couple of months-- for reasons not related to its effectiveness or SE-- so I'm going to watch my own reactions, too.
Jost
Posted by Phillipa on November 22, 2006, at 12:07:36
In reply to Re: Getting ready to start on Ensam patch, can I s, posted by Jost on November 22, 2006, at 10:16:05
Stargazer has a thread on EMSAM she has been on it about a week and is daily posting. Hopefully you will all do well as I still have my two boxes of samples and quite frankly am desperate. But how come my pdoc said I would need a washout from 25mg of luvox for two weeks? Love Phillipa
Posted by tensor on November 22, 2006, at 12:51:06
In reply to Re: Getting ready to start on Ensam patch, can I s, posted by Phillipa on November 22, 2006, at 12:07:36
>But how come my pdoc said I would need a washout from 25mg of luvox for two weeks?
"...Several adverse effects have been reported when fluoxetine and selegiline have been used together. A recent survey revealed that the incidence of a true serotonin syndrome is, however, very low with this combination. Concomitant use of selegiline and other selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) like citalopram, which have generally less interactions than fluoxetine, seems to be well tolerated. Nevertheless, caution is advised when combining a SSRI or a tricyclic antidepressant and selegiline."
Heinonen EH, Myllyla V
Orion Pharma, CNS Drugs, Turku, Finland.
Drug Saf 1998 Jul; 19(1):11-22
-------------------------/Mattias
Posted by stargazer on November 22, 2006, at 19:07:16
In reply to Re: Getting ready to start on Ensam patch, can I s » Phillipa, posted by tensor on November 22, 2006, at 12:51:06
Emsam package insert:
Section: Use with other Drugs affecting Monoamine Activity"After stopping treatment with SSRI's, SNRI's, TCA's, MAOI's, meperidine and analgesics such as tramadol, methadone, and Propoxyphene, detromethorphan, St John's wort, mirtazapine, bupropion HCL or buspirone HCL, a time period equal to 4-5 half lives (approx 1 week) of the drug or any active metabolite should elapse before starting therapy with Emsam. Because of the long half life of Fluoxetine and its active metabolite, at least 5 weeks should elapse between discontinuation of fluoxetine and initiation with EMSAM. At least 2 weeks should elapse after stopping EMSAM before starting therapy with buspirone or a drug that is contraindicated with Emsam."
So the washout period is one week for most drugs with the exception of Prozac (5 weeks) and Buspar (2 weeks).
Posted by Phillipa on November 22, 2006, at 19:24:47
In reply to EMSAM washout period, posted by stargazer on November 22, 2006, at 19:07:16
Thank you stargazer I'll make sure to let my pdoc know. That is great news. Love Phillipa
Posted by want2breal on November 22, 2006, at 20:20:38
In reply to EMSAM washout period, posted by stargazer on November 22, 2006, at 19:07:16
Did I mention that when I went to pick it up at the pharmacy today they said that if my insurance didn't approve it, it would cost $500....Later on, the pharmacy called and said it was okayed, and that it would be $45!!! Yippee!!!
I am excited about starting it, and very hopeful.
I will keep everyone posted....
Friday is the start day....
Posted by Phillipa on November 22, 2006, at 21:07:40
In reply to Re: EMSAM washout period, posted by want2breal on November 22, 2006, at 20:20:38
Oh great wonder if you and stargazer can post a thread together? Love Phillipa
Posted by RN320 on November 23, 2006, at 9:58:24
In reply to Getting ready to start on Ensam patch, can I still, posted by want2breal on November 21, 2006, at 23:15:58
Welcome to the EMSAM club.....so far it seems pretty exclusive. I've been on it since early June of this year and I've done really well. My washout from Wellbutrin XL and Lexapro was one week. My EMSAM dose has been gradually increased to the 12mg patch now, so I have a few dietary restrictions. It took about 7-8 days for me to see any difference, and the initial changes were pretty subtle- not really related to mood, but I found that I was able to accomplish more and that my mind wasn't quite so disconnected. At the 12mg dose I am now able to read a book for 30-45 minutes at a time and retain information as long as conditions are optimal. I find that the suicidal ideation is much more manageable on the EMSAM.
You're right about the cost- it's staggering. I'm a medicare recipient, so I have one of their drug plans- I have "gap" coverage this year, but next year no plans in my area are offering gap coverage for brand name drugs so I asked my pdoc to switch me over to the oral selegeline, which has been generic forever. My pdoc is so happy that I've done so well that he told me he will find some way to get me samples.
I tried to post initially about EMSAM back when I started, but I noticed a lot of negativity from other posters towards it so I stopped. Stargazer has opened the door for putting a positive experience out there, and I just wanted you to know that there's more than one. My pdoc is currently the largest prescriber of EMSAM in the Metro Detroit area and he says that every one of the patients that he's tried it on have done better (and he's only using it after failure of other meds).
I'll keep my fingers crossed for you. If you have any questions, please feel free to ask me.
Best wishes.
/m
Posted by Phillipa on November 23, 2006, at 19:43:54
In reply to Re: Getting ready to start on Ensam patch, can I still, posted by RN320 on November 23, 2006, at 9:58:24
I'm so glad you are going to post on EMSAM it is giving me the courage to try it again. Thanks so much Love Phillipa
Posted by want2breal on November 23, 2006, at 20:32:29
In reply to Re: Getting ready to start on Ensam patch, can I still, posted by RN320 on November 23, 2006, at 9:58:24
Thank you for your message. It means a lot that someone cares to post to you. It is so good to hear that you are having success on the Ensam patch. I will be posting about my experience with it, starting tomorrow. I am really praying that this helps me, because I've tried several different AD's, and nothing has seemed to really do anything for me so far. I hope you continue to do well.
Want2brealI've been on it since early June of this year and I've done really well. My washout from Wellbutrin XL and Lexapro was one week. My EMSAM dose has been gradually increased to the 12mg patch now, so I have a few dietary restrictions. It took about 7-8 days for me to see any difference, and the initial changes were pretty subtle- not really related to mood, but I found that I was able to accomplish more and that my mind wasn't quite so disconnected. At the 12mg dose I am now able to read a book for 30-45 minutes at a time and retain information as long as conditions are optimal. I find that the suicidal ideation is much more manageable on the EMSAM.
>
> You're right about the cost- it's staggering. I'm a medicare recipient, so I have one of their drug plans- I have "gap" coverage this year, but next year no plans in my area are offering gap coverage for brand name drugs so I asked my pdoc to switch me over to the oral selegeline, which has been generic forever. My pdoc is so happy that I've done so well that he told me he will find some way to get me samples.
>
> I tried to post initially about EMSAM back when I started, but I noticed a lot of negativity from other posters towards it so I stopped. Stargazer has opened the door for putting a positive experience out there, and I just wanted you to know that there's more than one. My pdoc is currently the largest prescriber of EMSAM in the Metro Detroit area and he says that every one of the patients that he's tried it on have done better (and he's only using it after failure of other meds).
>
> I'll keep my fingers crossed for you. If you have any questions, please feel free to ask me.
> Best wishes.
> /m
Posted by want2breal on November 23, 2006, at 20:34:19
In reply to Re: Getting ready to start on Ensam patch, can I still » RN320, posted by Phillipa on November 23, 2006, at 19:43:54
Phillipa,
Take heart, everything will be okay. We have to keep telling ourselves this.
Yes, I will post tomorrow as soon as I get the patch on, and I will post daily.
When are you going to start up again?
When did you say your washout pd. is over?
WANT2B
Posted by Phillipa on November 23, 2006, at 20:38:06
In reply to Phillipa...., posted by want2breal on November 23, 2006, at 20:34:19
To be honest they are trying to regulate my thyroid that just went after 9years from hypo to hyper. Next blood work on Dec21 but by then you will be well and I'll be ready to start. My New Years resolution. Love Phillipa
Posted by want2breal on November 23, 2006, at 20:41:18
In reply to Re: Phillipa.... » want2breal, posted by Phillipa on November 23, 2006, at 20:38:06
Bless your heart. Yes, all will be fine. I do pray that this is the medication for me....
I need to be up on things as I have a lot on my plate, as I know we all do.
Sorry about your thyroid. I'm not too informed about that condition. How does it relate to depression?
I hope your bloodwork comes back okay and that you get to start in Dec. That is not too far off, so keep the faith.
Posted by Phillipa on November 23, 2006, at 20:46:42
In reply to Re: Phillipa...., posted by want2breal on November 23, 2006, at 20:41:18
It has a lot to do with it. I'd advise googling hasimotos thyroidistis. A lot of info. Have you had any Ad's work for you? I really haven't . Benzos have been my mainstay for over 30years. When my thyroid went so do working and my ad experiences began. Love Phillipa
Posted by want2breal on November 23, 2006, at 20:56:06
In reply to Re: Phillipa.... » want2breal, posted by Phillipa on November 23, 2006, at 20:46:42
So, are you not able to work right now? That is terrible. Some AD's have helped me, but I am not usually able to tolerate the side effects. A lot of them make me really hyper, and I have terrible insomnia on them. I have never been on a Benzo, unless you count Ambien, which I take 5 mg. every night to help me sleeep. Most of the time I'm able to cope pretty well. I am trying to walk every day now. The reason I want to try the patch is because of all of the stresses I have in my life right now.
Later,
> It has a lot to do with it. I'd advise googling hasimotos thyroidistis. A lot of info. Have you had any Ad's work for you? I really haven't . Benzos have been my mainstay for over 30years. When my thyroid went so do working and my ad experiences began. Love Phillipa
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