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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 165 to 189 of 431. Go back in thread:
Posted by RobertDavid on April 21, 2006, at 14:42:31
In reply to Re: EMSAM-Day 15, posted by crabwalk on April 21, 2006, at 14:18:00
> Rob, have you (or anyone else) noticed any affect on libido? I'm very much hoping for a positive one myself. Probably starting the patch tomorrow.
It's better than before. I have more interest in it and for lack of better words I'm "performing better" with an increase in daily activity. I'm not sure how much has to do with my mood improving/feeling better or how much has to do with med side effect, either way, I've noticed a change for the better. Rob
Posted by germanium on April 21, 2006, at 20:14:53
In reply to Re: EMSAM-Day 15 » crabwalk, posted by RobertDavid on April 21, 2006, at 14:42:31
I'm taking Selegiline the active ingredient of Emsam & it does indeed improve your labido. Animal tests have also born this out with more frequent copulation from low performing animals to even old past thier prime animals that had stopped having sex start up again.
Posted by theo on April 22, 2006, at 14:32:54
In reply to Re: EMSAM-Day 15, posted by RobertDavid on April 21, 2006, at 14:00:59
Just curious, where are you placing your patch, upper or lower body? Does it work better in certain areas?
Posted by pederspd on April 22, 2006, at 14:59:56
In reply to Re: EMSAM-Day 5-Too early?? » pederspd, posted by RobertDavid on April 21, 2006, at 13:38:21
> > I am glad to see that people are doing well on Emsam. I was in a clinical trial for it almost 6 years ago and have been waiting for it to finally become available. During the 1st week of the trial I felt normal for the first time in my life. My only side effect was heartburn. All other anti-depressants had never worked and gave me horrible side effects. I received my prescription yesterday and am looking to have it filled in the Chicago area. CVS told me that they may have it in 3 or 4 months! My local Costco doesn't have it yet. I appreciate the name and number of the pharmacy in CA. I will order from there if I have to. Has anyone found a place to fill it in this area?
>
>
> I filled my perscription at Spencers Pharmacy in Riverside CA. The pharmacist said he'd mail perscriptions to people outside the area. I paid $440 and I think some of the bigger pharmacies are charging a little less, maybe he is now too. Anyway, If you want to order it thier number is 951-686-7373.
>
> I'd love to hear about your experience with EMSAM during the clinical trial. How long were you on it, what dose, how did you do, side effects, benefits? How did others do in the trial? Please elaborate. I'm assuming you want a perscription because you did well. Did you try other meds such as oral selegiline after the trial? It would be great to hear you're impute!
>
> Thanks Rob
>
>
>Rob-
I was in the trial where everyone was given the patch for the first 10 weeks then switched into the blind study part where you either continued on the drug or received placebo, but you didn't know which.Within 4 or 5 days on the patch I felt normal. No other medication had ever helped me before (or since). It was so wonderful. I was able to think clearly, get out of bed, enjoy life. My only side effect was heartburn. But that was easy to control with tums or rolaids. No other problems. We were only allowed to put the patch on the upper torso so I never tried it on my legs. I noticed no difference, tho, whether it was on my back, arm or chest.
When the change came, I knew within a week that I was on the placebo. I hit bottom sooooo quick. I was very suicidal. I recovered in about another week and returned to my previous state of depression. After that I went on the pill form of selegiline but it never worked. I think because there wasn't the continuous release.
I felt like Charlie did in Flowers for Algernon. I finally had experienced normal life and had it ripped away from me. So, I have been anxiously waiting for the release of emsam so that I can feel good again.
Posted by jetcity10 on April 22, 2006, at 15:32:14
In reply to Re: EMSAM-Day 15 » RobertDavid, posted by theo on April 22, 2006, at 14:32:54
> Just curious, where are you placing your patch, upper or lower body? Does it work better in certain areas?
I am only on day four (and have tried four different places) but, so far the best seemed to be the upper chest in that it seemed the least disturbed by movement during the day and at 24 hours looked almost new. Thigh was ready to fall off and lower back was hard to place for me. As to whether there is greater potential effectiveness with one area or another I have no clue, but as long as the patch stays intact and in place it doesn't "seem" like it should matter (for what that is worth...)
Posted by RobertDavid on April 22, 2006, at 23:27:58
In reply to Re: EMSAM-Day 15 » RobertDavid, posted by theo on April 22, 2006, at 14:32:54
> Just curious, where are you placing your patch, upper or lower body? Does it work better in certain areas?
I have been moving it to a different location each day. Today is the first day I have put it on my lower body (right side of stomach) and noticed no difference. Otherwise it's been on my upper chest, back or arm (both sides).
The instructions give you muliple options both upper and lower and I really don't think it matters. After 16 days I have yet to notice any difference that I can attribute to patch location. It's just working for me regarless of where I put it. Good luck! Rob
Posted by RobertDavid on April 22, 2006, at 23:49:23
In reply to Re: EMSAM-Day 15, posted by jetcity10 on April 22, 2006, at 15:32:14
I will say when I go to the gym I put it on an area that I'm not working so it will be less likely to fall off. I've not had it come of at all yet, but haven't tried the legs.
I have wondered though if it will not stick as well to my legs do to leg hair. I agree and think as long as you get it to stick tight, it probably doesn't matter where you put it.
Rob
Posted by RobertDavid on April 23, 2006, at 0:21:11
In reply to Re: EMSAM-Day 5-Too early??, posted by pederspd on April 22, 2006, at 14:59:56
Rob-
> I was in the trial where everyone was given the patch for the first 10 weeks then switched into the blind study part where you either continued on the drug or received placebo, but you didn't know which.
>
> Within 4 or 5 days on the patch I felt normal. No other medication had ever helped me before (or since). It was so wonderful. I was able to think clearly, get out of bed, enjoy life. My only side effect was heartburn. But that was easy to control with tums or rolaids. No other problems. We were only allowed to put the patch on the upper torso so I never tried it on my legs. I noticed no difference, tho, whether it was on my back, arm or chest.
>
> When the change came, I knew within a week that I was on the placebo. I hit bottom sooooo quick. I was very suicidal. I recovered in about another week and returned to my previous state of depression. After that I went on the pill form of selegiline but it never worked. I think because there wasn't the continuous release.
>
> I felt like Charlie did in Flowers for Algernon. I finally had experienced normal life and had it ripped away from me. So, I have been anxiously waiting for the release of emsam so that I can feel good again.
It is very encouraging to hear how well you did in the trial. Your response in the study seems just like mine this point. I've never had a positive response to any anti depressant before. I'm so encouraged!I find it very interesting that the patch worked significantly better than oral selegiline for you. That has been the topic of much debate and concern, that EMSAM just may not be that good because of how others have responded to taking it orally.
Many have been concerned that anxiety will be an issue with EMSAM because it seems to be an issue with oral selegiline. Would you mind expanding on the difference you felt between the two?
May I also ask if you know if your experience was similar to others in the study? The study showed that only 3.5% more people dropped out taking EMSAM vs placebo. That would suggest very few had enough side effects to quit. Do you have any insight regarding that?It must have been very difficult to have had such good luck, to have felt well for the first time and then have to wait all this time. I can only imagine how you felt!
Thanks so much for your insight. Rob
Posted by pederspd on April 23, 2006, at 4:27:45
In reply to Re: EMSAM-Day 5-Too early?? » pederspd, posted by RobertDavid on April 23, 2006, at 0:21:11
I only spoke with a few people in the study while we were in the waiting room. They were also having good luck while on the drug. One person was having problems with a lot of local irritation from the patch but that was all I heard about.
While on oral seleligline my only side effect was, once again, heartburn. (Never had it before the patch or since being off selegiline so I know it was connected to the drug only.) My doc and I struggled to find the right dosing for a long time. By the end I was taking 10mg every 3 hours around the clock. And I wasn't feeling any effect. I don't about other people, but the oral did nothing for me. After 2 years I gave up and decided to wait for the patch.
Posted by strugglingsteve on April 23, 2006, at 15:30:42
In reply to Re: EMSAM-Day 5-Too early??, posted by pederspd on April 22, 2006, at 14:59:56
Did you receive the 6,9 or 12 mg patch? Are you saying that you had a response the first week on the med? I am coming up on two weeks and no response for me yet but thankfully no side effects either.
> > > I am glad to see that people are doing well on Emsam. I was in a clinical trial for it almost 6 years ago and have been waiting for it to finally become available. During the 1st week of the trial I felt normal for the first time in my life. My only side effect was heartburn. All other anti-depressants had never worked and gave me horrible side effects. I received my prescription yesterday and am looking to have it filled in the Chicago area. CVS told me that they may have it in 3 or 4 months! My local Costco doesn't have it yet. I appreciate the name and number of the pharmacy in CA. I will order from there if I have to. Has anyone found a place to fill it in this area?
> >
> >
> > I filled my perscription at Spencers Pharmacy in Riverside CA. The pharmacist said he'd mail perscriptions to people outside the area. I paid $440 and I think some of the bigger pharmacies are charging a little less, maybe he is now too. Anyway, If you want to order it thier number is 951-686-7373.
> >
> > I'd love to hear about your experience with EMSAM during the clinical trial. How long were you on it, what dose, how did you do, side effects, benefits? How did others do in the trial? Please elaborate. I'm assuming you want a perscription because you did well. Did you try other meds such as oral selegiline after the trial? It would be great to hear you're impute!
> >
> > Thanks Rob
> >
> >
> >Rob-
> I was in the trial where everyone was given the patch for the first 10 weeks then switched into the blind study part where you either continued on the drug or received placebo, but you didn't know which.
>
> Within 4 or 5 days on the patch I felt normal. No other medication had ever helped me before (or since). It was so wonderful. I was able to think clearly, get out of bed, enjoy life. My only side effect was heartburn. But that was easy to control with tums or rolaids. No other problems. We were only allowed to put the patch on the upper torso so I never tried it on my legs. I noticed no difference, tho, whether it was on my back, arm or chest.
>
> When the change came, I knew within a week that I was on the placebo. I hit bottom sooooo quick. I was very suicidal. I recovered in about another week and returned to my previous state of depression. After that I went on the pill form of selegiline but it never worked. I think because there wasn't the continuous release.
>
> I felt like Charlie did in Flowers for Algernon. I finally had experienced normal life and had it ripped away from me. So, I have been anxiously waiting for the release of emsam so that I can feel good again.
>
>
Posted by egas on April 23, 2006, at 17:44:26
In reply to Re: EMSAM-Day 5-Too early??, posted by strugglingsteve on April 23, 2006, at 15:30:42
Hi,
All Walgreens and Costco in Lincoln Park in
Chicago CAN get the EMSAM PATCH...
but it is very expensive. Costco is less than
Walgreens. Target pharmacy manager in Chicago on Elston 773-252-2210 will sell
1/2 a box in case you go up on the higer dose
after 2 weeks. He has to order it so call before
going to fill it. I have awful insomnia and have not slept since I started the patch, even
with taking it off at night per my doctor. I am
afraid I am going to collapse from no sleep.
I can barely make it to work.good luck!
Hope this helps!!!
Posted by egas on April 23, 2006, at 17:51:54
In reply to EMSAM - insurance and dosage ?s, posted by tygereyes on April 11, 2006, at 21:44:21
Hi,
You can apply Benedryl cream over the patch
for the redness and irritation!Good luck!
Posted by ravenstorm on April 23, 2006, at 17:54:10
In reply to Re: EMSAM - insurance and dosage ?s » tygereyes, posted by egas on April 23, 2006, at 17:51:54
won't your doctor give you something for sleep? I would think taking off the patch is going to really lessen the chances of it working as an anti-depressant.
Posted by egas on April 23, 2006, at 18:18:51
In reply to Re: EMSAM - egas, posted by ravenstorm on April 23, 2006, at 17:54:10
Thanks, but my doctor said it is better to take
it off at night than to totally give up. He spoke
to 1 of the original researchers who recommeded taking it off at night, but I still
can't sleep much.I have tried all the sleeping pills, and only slept for 2-4 hours with them as well. I am
at my wits end. Most of the sleeping pills
make the depression worse, and I can't
take trazadone because I have a dry lung
conditions and it makes it much worse.
I have had it and am about to give up.Wish you the best!!!
Posted by RobertDavid on April 23, 2006, at 22:09:30
In reply to Re: EMSAM, posted by pederspd on April 23, 2006, at 4:27:45
pederspd:
How long did it take for EMSAM to start working for you when in the study? Did you initially have trouble sleeping and if so did that go away? What dose did were you on?
Thanks
Posted by pederspd on April 24, 2006, at 7:49:11
In reply to Re: EMSAM » pederspd, posted by RobertDavid on April 23, 2006, at 22:09:30
> pederspd:
>
> How long did it take for EMSAM to start working for you when in the study? Did you initially have trouble sleeping and if so did that go away? What dose did were you on?
>
> Thanks
>
>I found the patch worked in about 4 to 5 days. The dose I was on was the lowest 6/20. Never had any trouble with sleep while on the patch. Hope the insomnia gets better. It could be because the selegiline metabolizes in the body similiar to amphetamine and methamphetamine.
Posted by lymom3 on April 24, 2006, at 9:38:11
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
I can't wait to be able to start on this patch. I just took my last day of Lexapro and am on my 1 week washout period now. No SSRI, SNRI or TCA has worked for me yet and I know that I am my pdoc's experiment right now and I'm ok with that. This is at least a class of meds that I haven't tried yet. Anybody know what kind of sinus/cold medicine that I can take once I start this?
Posted by stowe on April 24, 2006, at 11:15:10
In reply to Re: EMSAM - First Day, posted by lymom3 on April 24, 2006, at 9:38:11
> On that note of what you can take with Emsam....can you take ativan to help with sleep with it?? I also, am hoping to try emsam, but have to explore a few details first. I have been on all different classes of Adep's with intolerable side effects to most. I am currently taking remeron, but can't stay on this forever. The sedation is killing my life, almost as badly as the depression....
So, any info on taking ativan and being on emsam?
thanks so much to all who are writing in and good luck,
gigi
Posted by RobertDavid on April 24, 2006, at 11:23:14
In reply to Re: EMSAM - First Day, posted by stowe on April 24, 2006, at 11:15:10
> So, any info on taking ativan and being on emsam?
I was taking klonopin when I started EMSAM and still do. I don't think there's any problems with taking benzo's (including ativan) and EMSAM or any MAOI for that matter.It probably helps taking a benzo when you first start EMSAM (or any MAOI) to help with any initial side effects you may get have such as insomnia.
That said, certainly not everyone will need to. You could always start EMSAM and take ativan as needed.
Rob
Posted by jetcity10 on April 24, 2006, at 11:38:40
In reply to Re: EMSAM - First Day » stowe, posted by RobertDavid on April 24, 2006, at 11:23:14
> > So, any info on taking ativan and being on emsam?
>
> I was taking klonopin when I started EMSAM and still do. I don't think there's any problems with taking benzo's (including ativan) and EMSAM or any MAOI for that matter.
>
> It probably helps taking a benzo when you first start EMSAM (or any MAOI) to help with any initial side effects you may get have such as insomnia.
>
> That said, certainly not everyone will need to. You could always start EMSAM and take ativan as needed.
>
> RobI too am taking Klonipin with the EMSAM and have had no problems with insomnia. In fact I think that I am sleeping better than I was before starting the EMSAM
Posted by SFY on April 24, 2006, at 13:03:36
In reply to Re: EMSAM-Day 5-Too early?? » pederspd, posted by RobertDavid on April 23, 2006, at 0:21:11
> May I also ask if you know if your experience was similar to others in the study? The study showed that only 3.5% more people dropped out taking EMSAM vs placebo. That would suggest very few had enough side effects to quit. Do you have any insight regarding that?
Don't get me wrong, I'm not an Emsam doubter. (In fact, it's going to be my next step if my current meds regimen doesn't pan out.) But I don't think we should minimize the ocurrence of side effects (and interpreting statistics correctly will help us all to better understand study results).
In the study earlier cited, 7.1% of Emsam users dropped out due to adverse effects versus 3.6% of placebo users. 7.1% is not 3.5% higher than 3.6% but nearly 100% higher since nearly twice as many people on Emsam dropped out than those on placebo.
If we had a total sample size of 1000 in the study, then 71 Emsam users and 36 placebo users would have dropped out. Thus 35 more or 97% more Emsam users than placebo users dropped out due to adverse reactions. If it were only 3.5% more than there would have been only 1 (0.035 x 36) more person dropping out which was clearly not the case.
Thus Emsam's side effects (or at least their severity leading to discontinue treatment) are noticeably greater than those encountered with placebo.
Posted by crabwalk on April 24, 2006, at 19:09:15
In reply to Re: EMSAM-Day 5-Too early??, posted by SFY on April 24, 2006, at 13:03:36
On this note, I'm getting some pretty bad anxiety from emsam on day 3. It's been sort of a rollercoaster ride so far. Very depressed and anxious the first day in a way that I'm not usually depressed. A little better yesterday, especially in the evening, and then this morning started getting my hopes up. Was feeling pretty good until maybe 10:30 and then all of a sudden I crashed and got very, very anxious, though not necessarily agitated. Been pretty anxious the rest of the day, but at least some of this is due to external factors.
I'm a pretty atypical case though, since I'm looking for something that will undo the damage to my sexual functioning that ssris did. This probably wouldn't have been my first choice just for anxiety, which is what I had to begin with.
Has anybody else hit anxiety, and does anybody know if it could wear off like it does for some with wellbutrin?
> Don't get me wrong, I'm not an Emsam doubter. (In fact, it's going to be my next step if my current meds regimen doesn't pan out.) But I don't think we should minimize the ocurrence of side effects (and interpreting statistics correctly will help us all to better understand study results).
>
> In the study earlier cited, 7.1% of Emsam users dropped out due to adverse effects versus 3.6% of placebo users. 7.1% is not 3.5% higher than 3.6% but nearly 100% higher since nearly twice as many people on Emsam dropped out than those on placebo.
>
> If we had a total sample size of 1000 in the study, then 71 Emsam users and 36 placebo users would have dropped out. Thus 35 more or 97% more Emsam users than placebo users dropped out due to adverse reactions. If it were only 3.5% more than there would have been only 1 (0.035 x 36) more person dropping out which was clearly not the case.
>
> Thus Emsam's side effects (or at least their severity leading to discontinue treatment) are noticeably greater than those encountered with placebo.
Posted by Donna Louise on April 24, 2006, at 20:40:44
In reply to Re: EMSAM - First Day, posted by lymom3 on April 24, 2006, at 9:38:11
> I can't wait to be able to start on this patch. I just took my last day of Lexapro and am on my 1 week washout period now. No SSRI, SNRI or TCA has worked for me yet and I know that I am my pdoc's experiment right now and I'm ok with that. This is at least a class of meds that I haven't tried yet. Anybody know what kind of sinus/cold medicine that I can take once I start this
Hey, sorry, can't help with the sinus med, I myself will have to find something to help with migraines. I finally found Maxalt, it is excellent for me and now I won't be able to take it. My question to you is that I understand you to say you will just need a one week washout. I am dying here on my effexor washout and was told to go two weeks but it seems the literature indicates one week is sufficient. so (finally the question) did your pdoc say one week is good enough? I sure hope so. I am going to have to find out if I need to go a week washout from migraine medicine as i have had to take it every day with this effexor withdrawal. Anyone know about that btw?
Thanks so much,
Donna
Posted by cecilia on April 24, 2006, at 20:54:44
In reply to Re: EMSAM-Day 5-Too early??, posted by crabwalk on April 24, 2006, at 19:09:15
Re side effects and Emsam (or any other drug), one thing to remember is that you're always going to have LOTS more side effects in the real world than in a clinical trial. That's because clinical trials are usually strictly limited to participants who have only the one condition being tested for. They were testing Emsam for depression and they wanted good results-people with anxiety as well would not have been allowed in the study. Real world-most people who have depression also have anxiety or other physical/psychological problems. I'm still planning to try Emsam, though, haven't got anything to lose. I'm getting very frustrated with the usual bureauocratic delays in my HMO though. I was told that my doctor needed to request it, they would send me a denial, and then I could appeal. I called last Wednesday and they said the denial letter had gone in the mail that day. Never received it, I called again today, they had no evidence it had been sent, assured me it would be sent today. We'll see. This is the same HMO that made me wait 4 months for knee surgery. The surgery didn't help anyway, and most likely Emsam won't, but I still want to try it. I am afraid, though. I'm so anxious already, and I'm afraid it will be like what was (for me) the worst drug ever made, Parnate Someone wrote in a recent thread about anxiety getting better as you get older. Not for me, unfortunately. I just get anxious about different things. Cecilia
Posted by egas on April 24, 2006, at 22:18:05
In reply to Re: EMSAM - First Day, posted by stowe on April 24, 2006, at 11:15:10
> > On that note of what you can take with Emsam....can you take ativan to help with sleep with it?? I also, am hoping to try emsam, but have to explore a few details first. I have been on all different classes of Adep's with intolerable side effects to most. I am currently taking remeron, but can't stay on this forever. The sedation is killing my life, almost as badly as the depression....
Will ask about Ativan....it always made me depressed in the past after 1 day...will not see
my doctor for another week, but will ask for you.!Good luck!
>
> So, any info on taking ativan and being on emsam?
>
> thanks so much to all who are writing in and good luck,
> gigi
>
>
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