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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 And K on November 28, 2010, at 17:25:22
Just discharged from the hospital after an unsuccessful ECT Trial (14 treatments) and placed on Emsam patch. Had to stop Emsam due to increased depression and suicidal ideation and intolerable nausea. Wanting to start a new medication (Effexor/Wellbutrin) but a two week washout period is recommended to avoid interactions. Cannot reach my Pdoc for a few days. My question...is it absolutely necessary to wait the full two weeks considering I was only on the medication for two days at the lowest possible dose - 6mg day. Would like to get started back on meds ASAP. Thanks in advance for your thoughts.
Andy K.
Posted by ed_uk2010 on November 28, 2010, at 17:31:46
In reply to Emsam Question, posted by And K on November 28, 2010, at 17:25:22
Interactions involving MAOIs can be severe so I think it's better to err on the side of caution and wait the full 2 weeks.
Posted by Phillipa on November 28, 2010, at 17:58:05
In reply to Re: Emsam Question, posted by ed_uk2010 on November 28, 2010, at 17:31:46
Were you on meds during the ECT? And the ECT didn't work so started on EMSAM? Must have been horrible side effects to only stay on med for two days. So the doc took you off and then prescribed effexor/wellbutrin and said wait two weeks before starting? No memory loss from the ECT? Just curious why the EMSAM was aborted so quickly Phillipa
Posted by And K on November 28, 2010, at 18:22:11
In reply to Re: Emsam Question, posted by Phillipa on November 28, 2010, at 17:58:05
> Were you on meds during the ECT? And the ECT didn't work so started on EMSAM? Must have been horrible side effects to only stay on med for two days. So the doc took you off and then prescribed effexor/wellbutrin and said wait two weeks before starting? No memory loss from the ECT? Just curious why the EMSAM was aborted so quickly Phillipa
Off all meds before starting ECT. Going on 6 weeks now. No memory loss from ECT, but no benefit either. Started back on meds upon completion. Emsam (MAOI) chosen due to the atypical features of my depression (fatigue, lethargy, increased appetite) and the fact that its one of the few meds I haven't tried. (Previously failed a trial of Parnate 70 mgs/day). Side effects on EMSAM were severe enough for me to want to stop ASAP. Have been able to push through most medications/side effects without much of a problem. This was different. Thought of going back on Effexor/Wellbutrin combo that had been partially successful a long time ago. Feeling the need to get meds back in my system ASAP and impatient about waiting an additional two weeks to do so. Thought I might be able to bypass the normal two week rule considering I was on Emsam for such a short period of time and such a low dose. Would obviously like to avoid any severe complications so waiting may be necessary.
Posted by Phillipa on November 28, 2010, at 20:24:18
In reply to Re: Emsam Question, posted by And K on November 28, 2010, at 18:22:11
I don't think this has ever come up before. I honestly don't know what to say except good luck. And that I emphatize with you. Phillipa
Posted by emmanuel98 on November 29, 2010, at 20:16:05
In reply to Emsam Question, posted by And K on November 28, 2010, at 17:27:39
The danger of not doing a proper washout is serotonin syndrome which can be fatal. That's why docs make you do a washout before or after an MAOI.
Posted by And K on November 29, 2010, at 21:15:44
In reply to Re: Emsam Question, posted by emmanuel98 on November 29, 2010, at 20:16:05
Yeah. I've been coming to that conclusion based on everything I'm reading. Thanks for your input. It's very much appreciated.
Posted by softheprairie on November 30, 2010, at 7:50:15
In reply to Emsam Question, posted by And K on November 28, 2010, at 17:25:22
I don't think you can have an "antidepressant" during the washout, but maybe something like Zypreza could get you through the waiting period.
Posted by autistic_narcopeltic on November 30, 2010, at 17:19:06
In reply to Re: Emsam Question, posted by softheprairie on November 30, 2010, at 7:50:15
How long after the ECT did you start the Ensam? I would like to argue that the ECT post effects can last up to a month perhaps longer while the brain recovers. Anyone else agree?
Posted by And K on December 1, 2010, at 6:07:36
In reply to Re: Emsam Question, posted by autistic_narcopeltic on November 30, 2010, at 17:19:06
> How long after the ECT did you start the Ensam? I would like to argue that the ECT post effects can last up to a month perhaps longer while the brain recovers. Anyone else agree?
Started Emsam a few days post ECT.
This is the end of the thread.
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