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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by War-Face on November 3, 2007, at 20:39:35
Anyone doing well on half a 6 mg patch per day? I've been taking the 6 mg patch for two weeks, sleeping with a 3 mg patch on, (cutting the 6 mg in half before application and leaving only half on during the night), and my anxiety is through the roof. I've been having panic attacks and agitation to the point where I cannot concentrate.Ultimately, I will give this 4 more weeks, but it clearly needs to be adjusted in some way.
Posted by Phillipa on November 3, 2007, at 21:36:56
In reply to Anyone doing well on Emsam 3 mgs?, posted by War-Face on November 3, 2007, at 20:39:35
Warface I have two boxes here from my pdoc was going to try it but have such high anxiety she decided no but she had said when we were planning on using it that I might only need a quarter of a patch so maybe you could try that and then take it off at night as well. I think you have a lot of options plus a benzo with it. Good luck still want to try it myself. Phillipa
Posted by Racer on November 3, 2007, at 22:01:40
In reply to Anyone doing well on Emsam 3 mgs?, posted by War-Face on November 3, 2007, at 20:39:35
I'm at the two week mark at 6mg, and have no increased anxiety -- instead, increased depression, apathy, fatigue, sedation, and suicidal ideation. And today, a headache to beat all, though normal BP.
I'll stick it out for a while, too. Maybe it will be better for each of us.
Posted by War-Face on November 4, 2007, at 1:11:48
In reply to Re: Anyone doing well on Emsam 3 mgs?, posted by Racer on November 3, 2007, at 22:01:40
Racer: I was feeling the same for the first week. I had more fatigue and yes, suicidal ideation. My pdoc gave me a green light to use left over Ritalin which I tried for 2-3 days and seemed to work well, but then suggested I try provigil 200 mgs instead. I have not been tired, but I have been terribly anxious and irritable. The suicidal ideation remains, which is not pleasant at all.Tomorrow I will try no caffeine, 100 mgs of provigil, and I am about to remove the whole 6 mg patch for the night. I might wait to see how I fare tomorrow before I consider trying 3 mgs per day, or maybe I'll apply 3 mgs and give it a few hours.
I have high hopes for this med. It definitely needs some tweaking, but this can only go on for so long.
Posted by War-Face on November 4, 2007, at 18:38:05
In reply to Re: Anyone doing well on Emsam 3 mgs?, posted by War-Face on November 4, 2007, at 1:11:48
Well, I followed my own advice today. I lowered Emsam to 3 mgs, halved the Provigil and had only one cup of green tea instead of the usual 3 caffeine servings from coffee or tea.
I feel less agitated than I had for the past week, but I still have anxiety and some depression. I also feel a little fatigue and I am having difficulty concentrating. I feel cognitively sharper, but I cannot apply it because of the strange mix of irritability, agitation, and fatigue.
I don't know what to do at this point. I think I will continue on 3 mgs for a week and give this current exact setup a little more time.
But I do have Wellbutrin waiting in the wings.
Posted by Phillipa on November 4, 2007, at 18:43:25
In reply to Re: Anyone doing well on Emsam 3 mgs?, posted by War-Face on November 4, 2007, at 18:38:05
Warface will be following as this ties into what my pdoc said about smaller patches. And the lesser caffeine would cut down on anxiety. This is sounding good!!!!! Phillipa
Posted by War-Face on November 4, 2007, at 18:43:27
In reply to Re: Anyone doing well on Emsam 3 mgs?, posted by War-Face on November 4, 2007, at 18:38:05
One other thing: my feelings of depression, fatigue, irritability, ability to concentrate etc. seem to shift in waves throughout the day. I don't feel steady throughout the day like I did on other drugs. In other words, I feel like it kicks in and works really well or at least a particular way at various times in the day.
I wonder if this will go away?
Posted by War-Face on November 4, 2007, at 18:49:30
In reply to Re: Anyone doing well on Emsam 3 mgs? » War-Face, posted by Phillipa on November 4, 2007, at 18:43:25
Thanks Phillipa.
I meant to respond to your benzo suggestion... I tried them 3 different times with Wellbutrin (klonopin, xanax) and they always increased my depression significantly. They also wreaked havoc for my inattentive-ADD!
If I were you, I would consider trying 1/4 of the 6 mg patch, especially given the positive effects Robert David experienced after adding Emsam to benzos after years on them.
Posted by Phillipa on November 4, 2007, at 18:53:15
In reply to Re: Anyone doing well on Emsam 3 mgs? » Phillipa, posted by War-Face on November 4, 2007, at 18:49:30
I am need surgery first still talk occasionally to Robert off EMSAM except a couple of days a week for energy lasts a long time like prozac. And that's exactly what my pdoc said either a quarter of a patch which I would remove at night. Thanks for responding. Please update this is so great to hear. Phillipa
Posted by Phillipa on November 4, 2007, at 18:55:06
In reply to Re: Emsam PS, posted by War-Face on November 4, 2007, at 18:43:27
From my reading it should. Phillipa
Posted by War-Face on November 5, 2007, at 17:42:50
In reply to Re: Emsam PS » War-Face, posted by Phillipa on November 4, 2007, at 18:55:06
Today was my best day on Emsam so far, just at the 2 week threshold. First 12 days at 6 mgs, last 2 at 3 mgs. I cut down on caffeine significantly, from an estimated 200 mgs per day to an estimated 75 mg today, spread out.
That feeling of an "anxiety motor" that I had is almost all gone. At least it seems to have been kept at low revs all day.
Racer: no suicidal ideation today at all.
Could 3 mgs or portions smaller than 6 mgs be the way to go for those feeling too much anxiety on the 6 mgs patch?
Posted by Phillipa on November 5, 2007, at 19:36:43
In reply to Re: Emsam - Quieting the Anxiety Motor, posted by War-Face on November 5, 2007, at 17:42:50
Makes sense to me and that's exciting as after this surgery thing that will be the next small dose of patch and guess no more chocolate truffles or green tea. Phillipa
Posted by War-Face on November 6, 2007, at 20:37:29
In reply to Re: Emsam - Quieting the Anxiety Motor, posted by War-Face on November 5, 2007, at 17:42:50
Day 3 on 3 mgs was not as good as day 2. I am still depression and suicidal ideation free, and anxiety is low. Unfortunately, ADD has been really bad today. I've been battling fatigue all afternoon. Maybe it's time to bump the Provigil back up to 200 mgs.
Knowing Emsam, tomorrow will bring a new set of circumstances.
Maybe I need to alternate 6 mgs for 1 day, 3 mgs for 1 day.
The oral Selegiline is supposed to be more stimulating than this, maybe that is what I need?
Posted by Phillipa on November 6, 2007, at 21:39:03
In reply to Re: Emsam - Quieting the Anxiety Motor, posted by War-Face on November 6, 2007, at 20:37:29
Warface slow down on the changes give your body time to adjust I think I'd do the same for a few more days and then maybe raise the EMSAM and take off at night at least the first night and see how you feel. Phillipa
Posted by War-Face on November 6, 2007, at 22:22:39
In reply to Re: Emsam - Quieting the Anxiety Motor » War-Face, posted by Phillipa on November 6, 2007, at 21:39:03
You're right.
Thanks, that is sound advice.
I just want to get better so badly, and I feel it is within reach. But I should be thinking about adjustments over many days or weeks, not day by day.
This is the end of the thread.
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