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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by zonked on May 28, 2011, at 16:20:57
Sometimes I *really* hate being a mental patient.
For insurance reasons (don't ask!) I can't see my doctor until next week, and I had to remind myself that I am not the ultimate decision maker on this!
I'm barely hanging on with Klonopin until my appointment. I am craving food like you can't believe, eating even after I'm full (I've never had this problem!) and just generally anergic and uninterested in life.
The only thing that keeps me somewhat active is that I'm helping my Mom, who has a terminal illness and will be restarting chemotherapy next week. That gets me to do things like do the dishes, and take care of basics even though my reward circuitry is all screwed up.
I still can't make up my mind, whether I want to ask for Nardil or Emsam. My success with Nardil was great the first time; very limited in duration the second time, and the third time I think I gave up after several weeks.
Wondering if I should give the new Gavis generic Phenelzine a try... or request the Pfizer Nardil which was the only one available when Nardil did work for me.
I tried the selegiline pills once--they seemed to me to be somewhat like Wellbutrin - making me irritable and quick to anger. And enhancing libido and anxiety. :-) Dunno if the patch would be any different. (This was when I was paying for psych meds out of pocket and couldn't afford the patches. Now they're formulary.)
Ugh. It's so hard for me to focus on anything other than getting well, and when I can be on something that works again. I don't think non-depressives can ever understand quite what this is like.
-z
Posted by Phillipa on May 28, 2011, at 21:52:12
In reply to The waiting game.. Nardil or EMSAM?, posted by zonked on May 28, 2011, at 16:20:57
Zonked I'm so sorry about your Mom and hope the prognosis is good for her. How hard this must be for you and your Mom. And you are shouldering all the responsibilities yourself that is awesome. What a wonderful Son you are.
Now are you saying Emsam is now generic and doesn't cost $500 or just on your insurance plan? So you also work then? Personally I'd give the Emsam a shot since you wanted to in the past. Phillipa
Posted by zonked on May 28, 2011, at 23:03:51
In reply to Re: The waiting game.. Nardil or EMSAM? » zonked, posted by Phillipa on May 28, 2011, at 21:52:12
> Zonked I'm so sorry about your Mom and hope the prognosis is good for her. How hard this must be for you and your Mom. And you are shouldering all the responsibilities yourself that is awesome. What a wonderful Son you are.
Aw thank you, Phillipa, as always for your kind words =) She struggles with depression herself, so she sort-of understands, but she isn't as treatment resistant as I am.
> Now are you saying Emsam is now generic and doesn't cost $500 or just on your insurance plan? So you also work then? Personally I'd give the Emsam a shot since you wanted to in the past.The goal is to get me well enough to be able to work again....I am lucky to have coverage through Medicare (due to disability, not age), and my drug plan covers Emsam. The copay is negligible, I think $1.20 for all drugs (except benzos, which is covered by the Medicaid I also have.)
-z
Posted by floatingbridge on May 29, 2011, at 13:02:02
In reply to Re: The waiting game.. Nardil or EMSAM?, posted by zonked on May 28, 2011, at 23:03:51
Zonked,
I probably didn't read your post correctly. Why are you choosing between the two?
Emsam does makes me more cranky and practically immune to benzos. The benzo tolerance is scary. The crankiness, I'm afraid is just my true self unchained.
Emsam certainly can be energizing. Sounds like you've taken Nardil. If yes, what factors are you weighing between the two?
fb
Posted by zonked on May 29, 2011, at 13:44:07
In reply to Re: The waiting game.. Nardil or EMSAM? » zonked, posted by floatingbridge on May 29, 2011, at 13:02:02
> Zonked,
>
> I probably didn't read your post correctly. Why are you choosing between the two?
>
> Emsam does makes me more cranky and practically immune to benzos. The benzo tolerance is scary. The crankiness, I'm afraid is just my true self unchained.
>
> Emsam certainly can be energizing. Sounds like you've taken Nardil. If yes, what factors are you weighing between the two?
>
> fb
>It's weird you mention the activating properties of Emsam... Granted, when I tried selegiline before, it was the capsules (and I forget the dosage), but it made me... angsty, and quick to anger. Helped somewhat with depression but drove anxiety up the wall. Wellbutrin had a similar effect on me.
The *only* reason I am afraid of taking Nardil again (since it HAS worked before) is that I'll be wasting my time and it won't work anymore. I feel, increasingly, that I don't have time to waste on (re)trials anymore. (But how do you know unless you try?)
Emsam is metabolized a bit differently when delivered via the patch (AFAIK) so it may be worth retrial.
Current symptoms: TERRIBLE waketime dread, I actually do think "what's the $(*#(*% point?" until I drag myself to have some coffee. That helps a bit and I just drag myself through the day until the next without engaging in formerly interesting hobbies, calling friends, responding to e-mails or Facebook pokes, phone calls, or whatever...music is flat and boring, getting out of the house I feel no better. Oh, and the VORACIOUS appetite since I stopped Parnate has not helped - I literally can't get the "satisfied full" feeling and at times have eaten until my stomach hurt from being over-full. I have no history of overeating. SO odd.
(You guys are familiar with the whole thing, I know.)
How long did it take Emsam to help you (I know it hasn't been a 100% solution for you) and at what strength?
-z
Posted by floatingbridge on May 29, 2011, at 13:55:52
In reply to Re: The waiting game.. Nardil or EMSAM?, posted by zonked on May 29, 2011, at 13:44:07
Zonked,
It's both helping and driving me nuts! My backstory is fibromyalgia (on top of major depressive f*ck-up) and my fatigue keeps me in bed. Or is it the depression? Oh, grrr.
Yes, it is stimulating. For someone w/o fibrio-maga-call-it, it could really get someone going.
If you've been on parnate and selegine, you know more than I about insomnia. I have ripped through my benzo supply. I have never done this.
The way I see it with my limited experience, try the emsam. If it doesn't work, can you drop back to 6mg for a week, then begin Nardil? Some posted above about transferring quickly from emsam to nardil. Maybe look it up.
Good luck. Did I catch all your questions?
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