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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 Darkness At Noon on August 5, 2007, at 16:59:24
I am now entering my 9th week on EMSAM. I've been at 9 mg for about 2 1/2 weeks.
Benefits: none to date.
Most bizarre side effect: previously, after putting on patch, I experienced several hours of heightened activation, followed by several hours of fatigue, followed by just plain activation.
Since going up to 9 mg, those several hours of fatigue became overwhelmingly intense, and occurred much sooner after putting on the patch. Then 20 hours of just plain activation. I was up to 3 mg Klonopin and getting about 4 hours nightly of bad sleep.
A week ago, I started applying the new patch at bedtime (instead of in morning). Then I take my sleep meds and get 4 hours of solid sleep. The period of fatigue is in sync with my sleep meds and time in bed. But once the patch fatigue changes into activation, I'm awake.
And tired, because 4 hours just isn't enough sleep. My pdoc won't, at this time, increase my Klonopin. We WILL discuss this further this week. I spend 20 hours a day stimulated by the patch but tired from lack of sleep.
Adding insult to injury, my sex drive and ability to perform have dropped below zero. I could personally restore honor and integrity to the Oval Office.I am not a happy EMSAM camper. But I am desperate, so soon I'll increase to 12 mg. Meanwhile, my big brain is too tired to do anything and my little brain is too deadened to do anything.
Posted by Phillipa on August 5, 2007, at 17:49:19
In reply to EMSAM At 8 Weeks, posted by Darkness At Noon on August 5, 2007, at 16:59:24
Try applying the patch in the morning and then maybe remove it at night. Just an idea. Love Phillipa four hours of sleep is not long enough.
Posted by yznhymer on August 5, 2007, at 20:12:41
In reply to Re: EMSAM At 8 Weeks » Darkness At Noon, posted by Phillipa on August 5, 2007, at 17:49:19
Thanks for the update.
"I could personally restore honor and integrity to the Oval Office."
ROFL Has it enhanced your sense of humor or are you normally this witty?
Seriously, I feel your pain. *bites lower lip*
(I'm not making light of you, just think a good laugh is good medicine and appreciate when someone throws one my way.) Those side effects truly stink - any one of them would. The debilitatiing results of sleep deprivation cut across the board. I've wrestled with sexual dysfunction of one sort or another when on SSRI's, Nardil, and other AD's (fortunately not with EMSAM so far) and after two or three months always came to the conclusion that it just wasn't worth it. My experience has been that the ED or more commonly anorgasmia never got better with time either. And what a kick in the teeth that the desire never left, just the necessary ability to satisfy it. *shakes fist at the heavens*I wish I were the kind of poster who could offer you some useful advice. When faced with endless sleepness nights I just stole naps whenever I could - it didn't make my nights any worse and it did help with my own functionality some. Its good to hear you're clear on your issues and determined to address them with your doctor. Best of luck with that.
I'm following the EMSAM posts with interest because I've been on it myself for about 6 weeks now, and I'm trying to glean some insights from other people's experiences, particularly about whether its worth giving a higher dose a try. So far so good - if I could get more of what I've been getting out of it more consistently, I could see my life changing. After a couple of decades (!) that's almost too much to comprehend.
Posted by Racer on August 6, 2007, at 0:24:21
In reply to EMSAM At 8 Weeks, posted by Darkness At Noon on August 5, 2007, at 16:59:24
Thank you for posting this. My pdoc has brought up EMSAM for me, and warned me that if I switch, sleep will be an issue. What have you tried for sleep? He's suggested Sonata, or maybe Rozerem, or back to Ambien, in the CR formulation this time. Have you had any luck with any of them?
And I hope things look up for you.
Posted by Darkness At Noon on August 6, 2007, at 2:46:53
In reply to Re: EMSAM At 8 Weeks » Darkness At Noon, posted by Phillipa on August 5, 2007, at 17:49:19
> Try applying the patch in the morning and then maybe remove it at night. Just an idea. Love Phillipa four hours of sleep is not long enough.
Unfortunately I'd still be stuck with the approximately four hours of fatigue when I applied the new patch in the morning. But this may be my next tactic.
No, 4 hours of sleep is NOT enough.
Posted by Darkness At Noon on August 6, 2007, at 2:55:46
In reply to Re: EMSAM At 8 Weeks » Darkness At Noon, posted by Racer on August 6, 2007, at 0:24:21
> Thank you for posting this. My pdoc has brought up EMSAM for me, and warned me that if I switch, sleep will be an issue. What have you tried for sleep? He's suggested Sonata, or maybe Rozerem, or back to Ambien, in the CR formulation this time. Have you had any luck with any of them?
I've been taking Ambien for years. I find that the CR version doesn't give me any more sleep, just makes me groggy when I do wake up.
In the past, adding Klonopin has compensated for stimulating meds. The problem right now is that my new pdoc won't prescribe more than 3 mg Klonopin. I think that another 1-2 mg might get me enough sleep.
This particularly peeves me, since I have a decade-long record of using Klonopin in this manner, and have never developed tolerance or dependency. Then the pdocs wonder why we have problems with compliance, or why I snort with disbelief at their claims that "sometimes the insomnia/sedation goes away after a few weeks/months". Right!
I tried Sonata a few years ago. I might as well have been taking M&Ms for all the sleep help it gave me.
YMMV.
Posted by Seeking Peace on August 6, 2007, at 7:13:35
In reply to Re: EMSAM At 8 Weeks » Racer, posted by Darkness At Noon on August 6, 2007, at 2:55:46
For me it seems that EMSAM and zyprexa comb is working. I put patch on during mid day (my sched is all screwey and hope to get it back to a.m.). I had a rough rough few months both thanks to Emsam anxiety/sleeplessness and family issues/work issues, etc. However it seems adding zyprexa has made me feel better. Don't give up yet. It took me almost 3 months before I added zyprexa. So i had 3 months of "i want off of EMSAM".
Hope it works for you.
Posted by d0pamine on August 6, 2007, at 10:30:04
In reply to EMSAM At 8 Weeks, posted by Darkness At Noon on August 5, 2007, at 16:59:24
I could tell very little about EMSAM until I stopped goofing off with the 9mg patch and slapped on the 12. There were lots of quickly fading strange little side effects that popped up for a day or so and went away but within 6 weeks it was all worth it as I was a new person (with insomnia)...If it were me doing it all over again I'd tolerate the insomnia until I knew the other parts were working for me, then I'd simply take 600mg of Potassium Citrate (divide dose morning and afternoon) as the potassium CITRATE (has to be citrate) completely wiped out my insomnia and allowed me to sleep as many hours as I wanted. but it may have also interfered with the EMSAM I don't know as I didn't stay on it long enough after that to determine, which why I recommend waiting until you feel good...of few weeks of a few hours less sleep likely will not kill you..in fact I go to where I was sleeping 3 to 4 hours / night and did that for about 10 months and loved it and seeming had no problems with it, just more time to get stuff done. oh yeah where I am having terrible sex side effects from parnate, I saw none with emsam except possibly a libido increase (as if I needed that). The only serious problem I remember was having to wait a whole 6 weeks on 12mg to start feeling better. Personally, I'd have to say that EMSAM basically rocks. (but not until 6 weeks on 12mg for me)
Posted by JohnSky on August 8, 2007, at 9:42:55
In reply to Re: EMSAM At 8 Weeks -- racer, posted by d0pamine on August 6, 2007, at 10:30:04
Are you off of EMSAM now, and if so, why did you stop?
Thanks
John
Posted by headcheese01 on August 11, 2007, at 8:09:08
In reply to EMSAM At 8 Weeks, posted by Darkness At Noon on August 5, 2007, at 16:59:24
Well, good luck with it. I hope the fatigue issues resolve for you.
I had to quit the stuff. It was making me sort of paranoid and more avoidant than usual. I was thinking dark thoughts.
Feel much better since quitting it a week ago, though I know it's been a godsend for some out there.
This is the end of the thread.
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