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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Bearfan on November 19, 2007, at 18:07:31
Dx: Atypical Depression, GAD, and mild OCD. Currently taking Cymbalta (and occasional xanax) it is helping relieve the symptoms but has the side effects of weight gain, sexual dysfunction and the upsetting of the digestive system (including bloating) are troublesome. I previously was taking Prozac for many years which was very helpful, but started to lose it’s effectiveness when I took on a more stressful full time job and starting attending grad school full time. The Prozac wasn’t as bad for weight gain and sexual side effects (but they still existed).
Was thinking about giving Emsam a try, although, I had some questions before I get started. The package insert reads that you must “wash out” of any SSRI/SSNIs for 5 days before therapy. I can live with this, but I am concerned (med sensitive), that if Emsam is a bust, that I have to wait two weeks of not taking anything before going back onto an anti-depressant (do I really have to wait that long?) If I only used Emsam for a week or two (and for some reason could not tolerate it) would I have still have to wait two weeks? One of the things that is appealing is that it is a patch so it completely bypasses the digestive system which may help lessen gastro effects and weight gain. Also I like the idea that on the lowest dose there isn’t any food restrictions. But I have never taken a MAOI and was wondering about the side effect profile. Based on the posts here, it appears that some folks had an excellent response with Emsam and they felt “side effect free” and not feeling ‘out of the picture’ as on SSRI type drugs. Do MAOIs generally have less side effects as a class, or is Emsam just unique with its delivery system or drug? Is it true it may not cause sexual side effects and weight gain at all?!
Also I haven’t heard much in if Emsam is effective with those who have anxiety disorders. Another MAOI, Nardil, is supposed to be really good with this. But it appears that Emsam main indication is on depression? It seems that its mechanism of action (increases serotonin, norepinephrine, and dopamine) that it may be helpful; although haven’t heard much about anxiety relief from it on this board.
In addition I am interested in the possibility of trying Ixel (Milnacipran), which is another SNRI that has supposedly has been available in Europe for many years. It claims that it doesn’t have the sexual effects or weight gain that are associated with Effexor and Cymbalta. I am assuming I have to purchase this overseas? Is this safe and can someone message me a reputable storefront? I am a bit confused why this drug has (apparently from a laboratory that is a sub-division from the Forest Labs) has not been submitted or marketed to the U.S. with its possibility of being a mutli-billion blockbuster drug for depression and/or pain and Fibromyalgia symptoms?
I know this may be a longish post, but I feel that my quality of life has suffered as I am not able to achieve 100% remission because of the side effects these drugs have. If anyone could please share some information, I would greatly appreciate itThanks
Posted by Phillipa on November 19, 2007, at 20:07:11
In reply to Thinking of Trying Emsam and/or Ixel, posted by Bearfan on November 19, 2007, at 18:07:31
Two week washout period and a lot feel anxiety so do a variety of things. Take off patch at night, cut it smaller, or take a benzo like klonopin with it good luck. Phillipa
Posted by bleauberry on November 20, 2007, at 17:34:52
In reply to Thinking of Trying Emsam and/or Ixel, posted by Bearfan on November 19, 2007, at 18:07:31
Milncipran is easily available mailorder over the net. I and others have done it. Though there is debate over the legality of it, it must be legal enough because every drug I've ordered from overseas arrived with a package that had been opened, inspected, retaped, and sent on its way, by the US Customs and had their green approval stamp on it. Generally speaking, a 90 day personal supply is allowed. If you are fortunate enough to have an open minded doc who will supply a prescription for it, then so much the better. But it isn't needed. The thing with overseas meds to be aware of is counterfeit drugs or paying money but not getting anything. I am not aware of any sources of Milnacipran that have those concerns. There are only a couple sources I am aware of and they are very legit popular sources.
Whether Ixel would be good for you is another story. Who knows. A personal trial is the only way to find out. I only tried it for 2 days. Definitely more energy, but also a very tired sleepy crash a few hours later (has to be multiple dosed), but I do not know if it was the depakote I had just increased the dose of, the Ixel, or something strange about the combo. I still have some and maybe should take another look.
As far as Ensam, I don't know that much about it. Some people do ok with it. It seems like most people don't get that much from it, or they wait a long time for it to kick in. I guess the main benefit I have heard a lot is that it gives a pretty quick boost of energy. I tried Deprenyl, the oral version of Ensam, and it did perk up my mood and energy immediately, but also came with some agitation and irritation that other people commented on. Worse, it created the most hidious repulsive obnoxious body odor on the planet. Not sure what that was all about. Maybe long term it might have done something for anxiety, but in the short term it created striking anxiety where none had existed, and it magnified existing anxiety to unbearable (2 different trials).
Posted by Bearfan on December 8, 2007, at 11:54:25
In reply to Thinking of Trying Emsam and/or Ixel, posted by Bearfan on November 19, 2007, at 18:07:31
bump, anyone else have experience?
This is the end of the thread.
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