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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Seeking Peace on May 27, 2007, at 21:06:59
Hi...kinda new here...hopefully someone can help me.
Guess my diagnosis first is primarily depression. I've never been sure what I'm diagnosed with. I have some borderline personality stuff too I suppose. Suffered depression for yrs. Been on diff meds and finally settled on welbutrin and zyprexa (some anxiety, thinking too much, etc lack of sleep etc). I seemed to do well on that combination and stayed on it for years. However even on it, I do go through times when I do get depressed and start thinking suicidal thoughts etc...well i think it's more of an ideation than being suicidal (not sure what the difference is though). So a bit back, going downhill, I stopped meds/treatment etc. Recently went back to psych doc and she says although the welbutrin/zyprexa works well for me, sometimes it's not working obviously and so put me on the Emsam patch 9mg. I guess I'm somewhat med/treatment resistant, though I can't say I've tried EVERYTHING. I have had several things over years, but no MAOI i think.
Anyways now I started this patch yesterday night (i asked her on phone if it was ok to start at higher dose at 9 than 6 and she says it's ok as I'm not new to meds etc...and I do trust her..that's not it). Anyways. I was scared to start a new med, an MAOI on top of it, so already had anxiety. Within half an hr of me putting it on (at night time..works better for me due to my sched), I started having anxiety and figured it couldn't be acting so soon, must be me being scared. Didn't sleep well...not that I ever really do..but maybe it was a lil more bad. Most of the day I was ok, sometimes anxiety kicks in (chest feels weird, like anxiety, feel anxious, etc, hard to explain) and I had to remind myself to calm down, breathe etc. anyways. I changed the patch again tonight and again within half hr of changing it, the anxiety seemed to creep in a bit more.
So my questions..
1) anyone else experienced this? Is it normal? I don't know if it's me being anxious taking the meds or it's anxiety due to the meds.2) I guess low bp is another problem that may come with it which i'll have to talk to doc about as I'm usually a lil on low side anyways.
3) does it cause insomnia. I had mentioned it to her and she would've put me on something for that but I decided to start only one new thing at the time. I'm very afraid to try new things...
4) Has it helped you? or not? How long before you see a change?
5) has anyone experienced the side effects (high bp) by not following the restrictive diet? My doc doesn't think i should be concerned but i'm still following it esp in beginning stages.
I decided due to anxiety to take off patch for the night and put it on in a.m. Anyone else tried to adjust the meds that way or by cutting off the patch? Any ideas? being a holiday weekend, I don't want to call or know if I should call the doc. so I'm trying to survive until Tuesday on my own. any ideas?Would appreciate any insight/advice/shared experience...please...thank you...
Posted by Phillipa on May 27, 2007, at 22:13:23
In reply to Emsam Patch, posted by Seeking Peace on May 27, 2007, at 21:06:59
A lot of people have started first at the lowest patch and seen how they react. Seems like a lot get insomnia aroung the fourth or fifth day. And a lot remove the patch during the night. I would google EMSAM on Dr. Bob's side and the EMSAM posts will come up. You sound frightened which causes anxiety. And some cut the patch to make it smaller but dont get it on your hand or fingers as it will go directsly into your system and a lot take klonopin for sleep with it. Good luck. Love Phillipa
Posted by KayeBaby on May 27, 2007, at 22:50:25
In reply to Emsam Patch, posted by Seeking Peace on May 27, 2007, at 21:06:59
>
> So my questions..
> 1) anyone else experienced this? Is it normal? I don't know if it's me being anxious taking the meds or it's anxiety due to the meds.Anxiety is extremely common at the beginning with EMSAM speaking from my own personal experience and reading ebverything I can find on the net about EMSAM. I have been on the 6mg patch for a little over 1 month. I have some slight anxiety, less than most people experience. I have had only slight problems with sleep at the very beginning. I also take ambien and quit taking stimulants when I started EMSAM so this probably accounts for my lack of tr4ouble in the sleeping dept.
> 2) I guess low bp is another problem that may come with it which i'll have to talk to doc about as I'm usually a lil on low side anyways.Mine has been pretty normal when I have checked it 130's over 70's and 80's. I believe the higher dosage of EMSAM may tend to cause more hypotension that the lower.
> 3) does it cause insomnia. I had mentioned it to her and she would've put me on something for that but I decided to start only one new thing at the time. I'm very afraid to try new things...Yes. Ask for something to sleep if you need it. I think quality sleep is very important.
> 4) Has it helped you? or not? How long before you see a change?It has helped me a lot and I have not had good luck with SSRI or SSRI's in the past. I have ADD and mild depression that is of the overeating/sleeping and just sort of blah variety. For me the energizing effects were noticable right away but the anti depressant effects didn't start kicking in until about 3 weeks. I feel like the anti-depressant effects are continuing to gradually increase almost day by day.
>
> 5) has anyone experienced the side effects (high bp) by not following the restrictive diet? My doc doesn't think i should be concerned but i'm still following it esp in beginning stages.Wouldn't hurt to watch it and see how you react to various things. The people in the trial did not react significantly if I am remembering correctly.
>
> I decided due to anxiety to take off patch for the night and put it on in a.m. Anyone else tried to adjust the meds that way or by cutting off the patch? Any ideas? being a holiday weekend, I don't want to call or know if I should call the doc. so I'm trying to survive until Tuesday on my own. any ideas?
If it were me I would cut the patch in half till you could talk to your Dr. and maybe take it off before you went to sleep if that helps. Seems like many people take it off before bed.> Would appreciate any insight/advice/shared experience...please...thank you...
Hope this helps. Try to stick it out if you can because compared to other ant-depressants I think EMSAM has so few side-effects. Weight neutral or some even lose, not much sexual problems etc.
Best of luck to you!
Kaye
Posted by Seeking Peace on May 28, 2007, at 7:05:30
In reply to Re: Emsam Patch » Seeking Peace, posted by Phillipa on May 27, 2007, at 22:13:23
You're right i"m awfully scared so I know that is not helping me distinguish betweem anxiety of meds versus anxiety due to meds. I don't deal well with anxiety or know how to control it when it's happening. I've been having insomnia off all meds for a while. Had gotten somewhat used to it, but a week or so back, it got worse. Then first night on the EMSAM it was anxiety added to that making it worse. I didn't know emsam acted so quickly. Does it seem unreasonable for me to say "within half hour, i seem to get more anxiety" and that insomnia was worse at first night itself? I took it off last night and felt a little better (i swear within half hour or so)...not totally, but a little. Over the night gradually more toward a.m., i relaxed more and did get some sleep. So I don't know. When I talk to doc, I will have to ask her for something to help me sleep as that's always been part of my problem.
Posted by Seeking Peace on May 28, 2007, at 7:20:07
In reply to Re: Emsam Patch, posted by KayeBaby on May 27, 2007, at 22:50:25
It's good to know that this med does work and am hoping after all this anxiety and trouble, it does for me too. I have a few more questions if you don't mind...
1) do you monitor your bp at home or something or at doc's office??? I don't know if I should buy something to do the same. Doc did say bp would need to be monitored but i'm not sure if she meant she would monitor it..but that's like once a week.
2) I was initially following schedule of putting it on at night, but i think that's going to go off now as night is when I have to take it off...so maybe I need to change schedule and put it on in a.m.?
3) Last night i took off the patch, left it on desk, uncovered etc. This a.m. I cut it off in half, tried to stick it on, it wouldn't. So if you are to take it off, how do you store or put it away so that next time it's still sticky and you can put it on?
4) This a.m. I took out one patch from it's sealed pouch, cut half, used half. Since it says that you should take out the patch only when ready to use, does that mean the other half (that has not been taken off the sticky thing) is no good anymore?
5) Can you take a shower etc with it? Does it matter if it's a hot shower? Can you put soap on/around it while showering?
6) is it recommended due to anxiety to be off all stimulants such as caffeine, coffee, soda, etc?
7) does it seem unreasonable for me to say "oh within half hour, i started getting more anxious etc". Is that my mind or can the med kick in that fast?
Thanks for all your help with this. I have like a zillion questions.
Posted by Seeking Peace on May 28, 2007, at 7:23:43
In reply to Re: Emsam Patch » Phillipa, posted by Seeking Peace on May 28, 2007, at 7:05:30
Oh and I forgot to say that last night even though i'd taken it off, I felt just a little, very slightly, nauseous during the night. Is that normal or it's just my anxiety?
Posted by KayeBaby on May 28, 2007, at 15:46:40
In reply to Re: Emsam Patch » KayeBaby, posted by Seeking Peace on May 28, 2007, at 7:20:07
> It's good to know that this med does work and am hoping after all this anxiety and trouble, it does for me too. I have a few more questions if you don't mind...
>
> 1) do you monitor your bp at home or something or at doc's office??? I don't know if I should buy something to do the same. Doc did say bp would need to be monitored but i'm not sure if she meant she would monitor it..but that's like once a week.Once a week should be fine unless you feel faint or get a bad headache or some other indication that your BP is out of whack. I don't know of any problems with the 6mg and blood pressure. A problem with either high or low would seem to be the exception rather than the rule so monitor it according to your comfort level and ask your Dr. to clarify when you see her.
>
> 2) I was initially following schedule of putting it on at night, but i think that's going to go off now as night is when I have to take it off...so maybe I need to change schedule and put it on in a.m.?Sounds like a good idea-just put it on first thing and see if that help you sleep better. Also, there is a search feature towards the top of this page right above where the posts start. Type in EMSAM and you will come up with pages and pages of people recounting their Emsam experiences some are even day-by-day.
>
> 3) Last night i took off the patch, left it on desk, uncovered etc. This a.m. I cut it off in half, tried to stick it on, it wouldn't. So if you are to take it off, how do you store or put it away so that next time it's still sticky and you can put it on?
>One thing I have learned with this patch is that the skin needs to be clean and dry. Alcohol wipes are good. The real trick is this-heat. I have discovered that if the patch is warmed after you apply it it really sticks! So, a warm hair dryer works well. Just warm the patch gently and evenly on clean, dry skin and you are set. I have found my rear to be the best place. It seems to work as well as the upper body placement and stays put very well there. Probably due the warmth.
> 4) This a.m. I took out one patch from it's sealed pouch, cut half, used half. Since it says that you should take out the patch only when ready to use, does that mean the other half (that has not been taken off the sticky thing) is no good anymore?
I know that with nicotine patches you have to leave the unused part in the foil pack for it to stay fresh. Emsam is probably the same. Look on the packet and you will see notches. These are cutting guides so you can cut the patch accurately without ever having to remove the unused portion.
>
> 5) Can you take a shower etc with it? Does it matter if it's a hot shower? Can you put soap on/around it while showering?
>If I get the thing on right to start with it is not a problem. But I do try to avoid soaping it.
> 6) is it recommended due to anxiety to be off all stimulants such as caffeine, coffee, soda, etc?
If you are having anxiety I would definately avoid any stims especially caffeine. Just cut way back so you don't get the headaches and stuff from withdrawal.
>
> 7) does it seem unreasonable for me to say "oh within half hour, i started getting more anxious etc". Is that my mind or can the med kick in that fast?
>Has this response been consistant? If so, then probably for you it start effecting you this fast. I am not prone to the anxiety side effect but I could discern the medication within an hour.
> Thanks for all your help with this. I have like a zillion questions.
You are welcome. I hope this medication will help you to feel better soon!Peace,
Kaye
Posted by Seeking Peace on May 31, 2007, at 18:32:21
In reply to Re: Emsam Patch, posted by KayeBaby on May 28, 2007, at 15:46:40
Thanks KayeBaby for responding...
Thought I'd put up an update....
After posting...well taking it off at night seemed to help eventually, as if I needed to calm/withdraw or something. On Tues (4th time), I was at work during day after putting it on (started putting in a.m.), and I didn't have anxiety. Maybe sitting home, I got scared??? I don't know. distraction helped. in p.m., spoke with pdoc, explained, suggested that I'd start putting on full patch during day but take it off at night. She thought it was possible i was getting some anxiety, said I should stay with half patch but to leave it on during night too. I did and actually that night was ok with sleep. Not best, but not any more horrible than premed. So even next day (Wed), did same, left on at night, slept ok..not worse. I have no anxiety now, maybe 1% of time. Makes me wonder if it's working??? feels like am taking a sugar pill...no effect, side effects.... I've been putting on about 2/3 or patch now..i may increase it tomorrow to the whole thing and see. Thing is I'm traveling/out of country for 2 months in about 3 wks...so this was not right time probably to start something new.
So far, the most annoying thing about this is taking it off...ouch...painful as I've got hair/lanugo??? (whatever that is called). Some spots more sensitive than others....
Will see how I feel in couple of days... Thank you for responding :)
Posted by justfoundhope on June 7, 2007, at 21:30:47
In reply to Emsam Patch, posted by Seeking Peace on May 27, 2007, at 21:06:59
I am terrified. I just started using EMSAM and am very hopeful about it, but I just found this article:
http://blogs.wsj.com/health/2007/05/01/bristol-myers-exec-dishes-on-depression-patch/
Are they going to stop manufacturing the EMSAM patch?
Posted by justfoundhope on June 7, 2007, at 21:31:09
In reply to Emsam Patch, posted by Seeking Peace on May 27, 2007, at 21:06:59
I am terrified. I just started using EMSAM and am very hopeful about it, but I just found this article:
http://blogs.wsj.com/health/2007/05/01/bristol-myers-exec-dishes-on-depression-patch/
Are they going to stop manufacturing the EMSAM patch?
Posted by Phillipa on June 7, 2007, at 22:30:11
In reply to IS EMSAM being pulled???, posted by justfoundhope on June 7, 2007, at 21:30:47
Wow and just when it seems that people were learning how to successfully use it. Maybe they will lower the price as that's the problem. Love Phillipa
Posted by justfoundhope on June 7, 2007, at 22:39:41
In reply to Re: IS EMSAM being pulled??? » justfoundhope, posted by Phillipa on June 7, 2007, at 22:30:11
Absolutely. It is clear that most people that are taking it love it. The posts on this board are what sold me on it. If they weren't charging a mortgage payment for our sanity, we may be able to keep this amazing drug on the market! I will keep up hope.
Posted by Iansf on June 8, 2007, at 0:40:08
In reply to Re: IS EMSAM being pulled??? » justfoundhope, posted by Phillipa on June 7, 2007, at 22:30:11
> Wow and just when it seems that people were learning how to successfully use it. Maybe they will lower the price as that's the problem. Love Phillipa
It's so obvious that the price is the problem, but Bristol-Myers execs seem to be too dense to comprehend that making Emsam more affordable would bring more sales. They'd apparently rather lose their investment entirely than make less money than they had hoped. So bizarre. And so wrong.
Posted by Honore on June 9, 2007, at 13:05:54
In reply to Re: IS EMSAM being pulled??? » Phillipa, posted by Iansf on June 8, 2007, at 0:40:08
Yeah-- but it is making some money-- and the investment is already made. I don't think they'll pull it. It's been too useful for too many patients-- and I think pdocs would really object.
I saw nothing in the article that suggested pulling it-- just that it hadn't been the big money-maker they'd hoped.
They should lower the price-- maybe they'll figure that out. They presumably understand how the market works.
Honore
This is the end of the thread.
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