![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 62 to 86 of 122. Go back in thread:
Posted by Donna Louise on July 8, 2006, at 22:35:46
In reply to Re: EMSAM doing nothing, posted by jealibeanz on July 8, 2006, at 15:44:36
> Sounds great for you Donna. What made your doctor to decide to move to 12 mg instead instead of decreasing? Why'd you pick EMSAM and not a more commonly used MAOI?
I decided to move up. I was still a little depressed on 9mg. I chose Emsam because of the transdermal delivery system
donna
Posted by jealibeanz on July 9, 2006, at 0:49:39
In reply to Re: EMSAM doing nothing » jealibeanz, posted by Donna Louise on July 8, 2006, at 22:35:46
You sound like you have quite a bit of freedom. That's nice. What does your doctor think about EMSAM? Did he take a lot of convincing? Is he now prescribing it for other patients?
Posted by t2green01 on July 9, 2006, at 7:44:49
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
I have been a disability for 2 years due to anxiety and depression. I have tried every ssri and ect treatment with very little or so success. My doctor wants me to have Vagal nerve stimulation but I could try Emsam if I want to try one more med. I dont know what to do
Posted by jaclinhyde on July 9, 2006, at 8:35:49
In reply to Re: Who's Still Going Strong with EMSAM?, posted by pulse on June 29, 2006, at 0:58:31
For everyone who has had no success with Emsam and has given up on the maoi's all I can say is WHY?
There are three other more powerful ones out there that put Emsam to shame (which I shouldn't say because I am on it myself only due to weight gain from the two of the others and a bad reaction to the third.) You want to see a kick *ss drug...try Nardil, Parnate or Marplan - the holy grail of MAOI's.
:-)
JH
Posted by 4WD on July 9, 2006, at 14:08:55
In reply to Re: EMSAM doing nothing » 4WD, posted by Phillipa on July 7, 2006, at 21:17:01
> Marsha why didn't you let me know you weren't here because of depression. They say that those that get better leave so I thought you were better. Please babblemail me can't remember if you have my E-mail address. Love Phillipa
Hi PHillipa,
You know how it is. YOu get into that place where it is an accomplishment just to get your socks on in the morning and the litter boxes cleaned.
Although I was doing better for a while on Celexa, Klonopin and Neurontin. NOt good but okay. Then I had about 10 days in a row of feeling awful and that's when I decided to give EMSAM a shot.
How are you? What meds are you on now? Last I heard you were still on Luvox?
Marsha
Posted by 4WD on July 9, 2006, at 14:12:59
In reply to Re: EMSAM doing nothing, posted by Jakeman on July 7, 2006, at 23:13:28
> > > What kind of med is Zyprexa and how does it help you? Why did you decide upon EMSAM and how long do you plan to continue for unless there are positive results?
> >
> > It's an atypical antipsychotic, one of the new ones, like Geodon or Seroquel. It takes away suicidal thoughts and lifts the depression to a degree that it's bearable.
> >
> > I'm not sure about the EMSAM. I guess I'll give it at least three weeks. Two on the 6mg and one more on the 9mg and if there is no improvement, I guess I'll ditch it.
> >
> > I tried EMSAM because I had such bad side effects on the SSRIs and tricyclics (and not a great response either).
> >
> > I have treatment resistant depression.
> >
> > Marsha
>
> Marsha it sounds like you are in the same boat with a lot of us here.
>
> warm regards, Jake
>Hi Jake,
Except it can't be a boat. Has to be a gigantic floating city since there are so many of us.
Maybe a community of depressed and anxious people wouldn't be such a bad idea. Nobody would ever be telling you that you just needed to have a positive attitude and stuff like that.
Marsha
>
Posted by 4WD on July 9, 2006, at 14:17:34
In reply to Re: EMSAM doing nothing » 4WD, posted by Donna Louise on July 7, 2006, at 23:14:05
> The only thing that I eat that is on the diet is tofu and I still eat it and nothing happens. I suspect nothing will happen if you eat anything on the list. I believe it is the FDA's concern and what held up marketing for so long, that the one test they did with 9 and 12mg (which showed no restrictions necessary) wasn't enough to for them to feel comfortable without putting in the restrictions. I am not advocating anyone ignore following the diet, I just don't intend to. I think the real danger in the higher dosage is the greater probability to a contra-indicated drug reaction. Tht should be the focus in my opinion. The transdermal absorbtion and subsequent by pass of first pass metabolism exists as much for 12 mg as 6mg. That is the way I see, it is in the realm of possibility that I could be wrong :-)) but I don't have a problem eating tofu.
>
> donna
>
> donna
>I think you are right. I don't intend to follow the diet either maybe very tentatively for the first week or two - little bit of soy, little bit of cheese, etc. In fact, my pdoc says that "theoretically" you are supposed to follow the diet at the higher dosages.
Truth is, I wouldn't mind the diet if the drug worked well. The diet only seems so offputting because I am depressed and everything seems offputting. I have noticed before that things that seem totally overwhelming when I am at my worst seem like nothing at all on a good day.
Thanks,
marsha
Posted by jealibeanz on July 9, 2006, at 15:32:44
In reply to Re: VNS or Emsam?, posted by t2green01 on July 9, 2006, at 7:44:49
I'm always so surprised when I read that people have tried every SSRI, sometimes more than once. I don't think my doctor would ever do that with me. I guess they all have different approaches. He just said I probably would have similar side effects and responses.
Others actually fed me the "personality" line, which I think is crap. Constant anxiety isn't due to personality. It may be partly caused by experiened, as in post traumatic stress, but not in my case. Depression, could be likened to someone with too high expectations out of life. I don't have this outlook. I'd settle for middle of the line, just being able to get through every day without dread and misery for no reason. I don't need a fairy tale ending. Also, my depressions and normal moods aren't dependent upon my life situations.
I've gone through periods where evvvvery thing was terrible every thing. Then periods when life was wondddderful. Nothing changed. I was doing the exact same thing as always. Same school, activities, friends, work, ect. This leads my to believe that it is at least partly chemical.
Posted by jealibeanz on July 9, 2006, at 15:35:47
In reply to Re: Who's Still Going Strong with EMSAM?, posted by jaclinhyde on July 9, 2006, at 8:35:49
Which did you try that caused weight gain? How's the EMSAM going?
Posted by Phillipa on July 9, 2006, at 20:54:21
In reply to Re: VNS or Emsam?, posted by jealibeanz on July 9, 2006, at 15:32:44
I agree I went through divorces, moving on my own to different states, Son on drugs joined the army lost eyesight in Desert Storm. Kids that don't even bother to call or aknowledge me and many job changes and working as a nurse in all units and psch and a prison. And I loved it. Then boom my thyroid went and I found out I had chronic lymes disease so there has to be something biological but what!!!!!!Love Phillipa
Posted by Phillipa on July 9, 2006, at 20:56:01
In reply to Re: EMSAM doing nothing » Phillipa, posted by 4WD on July 9, 2006, at 14:08:55
Marsha long story. Too long for here. Yes still on luvox but added lamictal. Just started for the second time and the same valium. Do you have my E-mail address? Love Phillipa
Posted by crazy777girl on July 10, 2006, at 3:43:50
In reply to Re: VNS or Emsam?, posted by t2green01 on July 9, 2006, at 7:44:49
I'm in a similar situation, non-responsive to treatment. I've bombed out w/ Emsam & am on a waitlist currently w/ Cyberonics for an implant. Many on the board here have seemed to benefit from Emsam, though. VNS is last resort - if all else has failed. If that's the case, though - I would strongly encourage you to talk w/ your pdocs & do your research. It may be a viable alternative for improvement. I am hoping it will be. Best of luck, A.
> I have been a disability for 2 years due to anxiety and depression. I have tried every ssri and ect treatment with very little or so success. My doctor wants me to have Vagal nerve stimulation but I could try Emsam if I want to try one more med. I dont know what to do
Posted by Kirkster on July 10, 2006, at 12:19:02
In reply to Re: VNS or Emsam? » t2green01, posted by crazy777girl on July 10, 2006, at 3:43:50
Confused about EmSam -
I was diagnosed as Bipolar Depression (cycle from norm. to depressed) and put on Lithium and Lamictal and doing great until Lithium toxicity (lots of fun!). I went down a bit on Lithium and so did my mood - big time. Now back up halfway on Lithium and not doing too well. Now my doc wants to try Emsam, but the idea of a MAOI is scary to me - been on every SSRI known to man, but not sure about trying Emsam. Is it worth a try or are the side effects so bad I should run away from it.Kirkster
Posted by iamme2 on July 10, 2006, at 14:33:13
In reply to Re: EMSAM doing nothing » jealibeanz, posted by Donna Louise on July 8, 2006, at 7:44:05
Donna,
I noticed in your post that you take lamictal as well as Emsam. I've been given lamictal to try along with Emsam, but doc and I agreed to start with the Emsam first to see how that goes. So far (at about day 11, 6mg patch) it is not working well at all. I feel physically ill (like I have the stomach flu), tired and groggy, and am a raving bitch to those close to me. I'm thinking I should start lamictal sooner rather than later. Can I ask what dosage of lamictal you started with? And, I'm wondering if I just haven't given Emsam enough time to start working. Geez, I just hate feeling so miserable!
Thanks for any help!
M
Posted by jealibeanz on July 10, 2006, at 19:40:56
In reply to Re: EMSAM doing nothing, posted by iamme2 on July 10, 2006, at 14:33:13
Is it possible for you to move up to 12 mg, to see if it help? Or would that be too much of a shock to your body?
Posted by Donna Louise on July 10, 2006, at 20:51:50
In reply to Re: EMSAM doing nothing, posted by iamme2 on July 10, 2006, at 14:33:13
> Donna,
>
> I noticed in your post that you take lamictal as well as Emsam. I've been given lamictal to try along with Emsam, but doc and I agreed to start with the Emsam first to see how that goes. So far (at about day 11, 6mg patch) it is not working well at all. I feel physically ill (like I have the stomach flu), tired and groggy, and am a raving bitch to those close to me. I'm thinking I should start lamictal sooner rather than later. Can I ask what dosage of lamictal you started with? And, I'm wondering if I just haven't given Emsam enough time to start working. Geez, I just hate feeling so miserable!
>
> Thanks for any help!
> MI am sorry you are feeling so lousy. I know exactly how it feels. Especially when you first start a drug you have high hopes for and it fails to meet the expectations. My expectations were way to high, I had waited so long for it..Anywya, no, you haven't given anywhere near enough time. And even after you do give it enough time at 6mg, you may have to go to 9 or 12 and then give that strenght enough time too. I am at 12 and that is working for me.
I did not start the lamictal until I had been on the patch about 6 weeks. It was working pretty good except for alot of irritability. That is the reason for lamictal addition. Which helped almost right away. Later, 6mg was not enough for the depression and neither was 9mg but 12 is good. And with the lamictal no more irritability either. I think both contribute to that.
When you start lamictal you should get a starter pack which has you on 25mg for two weeks, then 50 for two weeks, then 100 for two weeks and then from there you and your dr. decide whether to go higher. Each time you go up, you have to do it slowly or the risk of the Stevenson-Johnson rash gets higher. I have one more day of 50mg then I go to 100mg. I have had no side effects at all, another good reason to start low and go slow.
Try to be patient, I know it is hard because you don't want to be miserable a moment longer but that is just the way it is. And you may be richly rewarded if you don't quit before the fat lady sings...no slight intended to fat ladies. It is just a saying..
Hang in there and good luck.donna
Posted by Donna Louise on July 10, 2006, at 20:56:41
In reply to Emsam, et. al, posted by Kirkster on July 10, 2006, at 12:19:02
> Confused about EmSam -
> I was diagnosed as Bipolar Depression (cycle from norm. to depressed) and put on Lithium and Lamictal and doing great until Lithium toxicity (lots of fun!). I went down a bit on Lithium and so did my mood - big time. Now back up halfway on Lithium and not doing too well. Now my doc wants to try Emsam, but the idea of a MAOI is scary to me - been on every SSRI known to man, but not sure about trying Emsam. Is it worth a try or are the side effects so bad I should run away from it.
>
> KirksterMAOI's can cause a bipolar to have a manic episode as can SSRI;s. Did that happen to you with any one of the SSRI's? If it didn't, maybe you would be ok with an MAOI too.
Everyone is different, you may have no side effects at all. It seems from this board that most reported side effect is insomnia with irritablity a close second. I did not get insomnia and the addition of lamictal and the higher dosage of 12mg took care of the irritablity. So even if you do get a side effect or two, they may of the type that can be managed to where they are not a problem. Guess you won't know unless you try.donna
Posted by Phillipa on July 10, 2006, at 21:12:54
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 10, 2006, at 20:51:50
Donna I am on the starter pack too. Did it make you feel tired, any diarrhea? Headaches? Love Phillipa
Posted by Donna Louise on July 10, 2006, at 21:40:05
In reply to Re: EMSAM doing nothing » Donna Louise, posted by Phillipa on July 10, 2006, at 21:12:54
> Donna I am on the starter pack too. Did it make you feel tired, any diarrhea? Headaches? Love Phillipa
No, no side effects at all.
donna
Posted by iamme2 on July 11, 2006, at 11:12:05
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 10, 2006, at 20:51:50
Donna L.
Thanks so much for your (speedy) reply. I wimped out last night and took off the patch without replacing with a new one. I just could not take another day of feeling like absolute crap (while having to be at work, of course). I need to call the doc and see what he thinks about starting the lamictal and I'll ask about the side effects too. I've taken several SSRI's and have never had such severe reactions to any of them. I've switched to Emsam as all the SSRI's eventually petered out on me. Anyway, I'll put the patch back on tonight and just grit my teeth. I do feel better today without the patch, but I'll bet that's just psychological.
Thanks again,
M
Posted by Donna Louise on July 12, 2006, at 6:56:34
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 11, 2006, at 11:12:05
> Donna L.
>
> Thanks so much for your (speedy) reply. I wimped out last night and took off the patch without replacing with a new one. I just could not take another day of feeling like absolute crap (while having to be at work, of course). I need to call the doc and see what he thinks about starting the lamictal and I'll ask about the side effects too. I've taken several SSRI's and have never had such severe reactions to any of them. I've switched to Emsam as all the SSRI's eventually petered out on me. Anyway, I'll put the patch back on tonight and just grit my teeth. I do feel better today without the patch, but I'll bet that's just psychological.
>
> Thanks again,
> MHey, it is really hard to go to work when you feel so bad. Don't add feeling guilty to your other problems! Who knows, it may not be right for you. We have to just keep plugging along until we get it figured out. I wish you the best of luck with this.
donna
Posted by iamme2 on July 12, 2006, at 11:00:09
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 12, 2006, at 6:56:34
Donna,
After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
Megan
Posted by Donna Louise on July 12, 2006, at 21:52:14
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 12, 2006, at 11:00:09
> Donna,
>
> After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
>
> MeganI imagine if you like the Emsam enough, you can do something else for your BP. With the MAOI's usually low BP is only a problem when you stand up, orthostatic hypotension. My bp is normal.
I don't think lamictal is effective or recommended by itself very often. In unipolar depression, it is taken with AD. In bipolar depression, it is taken with another mood stabilizer. But who knows, maybe it would work for you. You never know unless you try it.donna
Posted by Phillipa on July 12, 2006, at 23:31:48
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 12, 2006, at 21:52:14
Sometimes lamictal is taken without an ad in unipolar depression. Love Phillipa
Posted by jkshrews on July 23, 2006, at 13:35:45
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
I'm going along OK after about 2 months. I'm at the 9 mg dose and intend to move up to 12 next week. I've found the best place to stick the patch and have it stay on for 24 hours is on the back of my shoulder, just over the crest. It has to go somewhere the skin doesn't experience much flexing.
During the drying-out period between stopping Wellbutrin and starting EMSAM, my firbromyalgia symptoms went nuts, but then settled down again after using the patches for a week.
I believe my mood is a bit improved compared to what I was taking before, and I have had a couple of really good days. Since this breaks down into d-amphetamine and methamphetamine, I was hoping for some resulting mood stimulation and some appetite reduction, but that hasn't happened yet. I think there are some sexual side-effects, but it is difficult to distinguish what is from the depression and what is from the drug.
I have experimented around with no-no foods as my dose has increased. So far, there is no problem with anything, but I do keep 50 mg of clorpromazine on me just in case.
I had started treatment for high blood pressure in January, and they wanted to increase the dose of my ACE inhibitor again in April, but I asked not to, since I was intending to start an MAOI, and I was concerned about the "additive hypotensive effect." When I went up to the 9 mg EMSAM patch, sure enough, my blood pressure went down into the normal range. I am wondering if at 12 mg EMSAM I will have to stop the ACE inhibitor.
--------------------------------------------
> I been considering this for months and wanted so badly it to be my next "wonder cure". I'm saddened by all the people who have had to discontinue. Is there anyone still doing well? Please share your story!
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.