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Dr. Bob is Robert Hsiung, MD,
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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
>
>
Posted by egas on April 24, 2006, at 22:27:27
In reply to Re: EMSAM-Day 5-Too early??, posted by crabwalk on April 24, 2006, at 19:09:15
I have had horrible anxiety and panic after
1 week on the patch...took more xanax, still
trying to hang in there, but feel no better yet
since I cannot sleep, even when I take the
patch off at night. I was late for work
today because I was drugged from Restoril, xanax and seroquel...got some sleep but
hung over all day and felt lousy...time for
bed now and still hung over but can't sleep.
I am about to stop the patch....Best to you!> 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 strugglingsteve on April 24, 2006, at 23:38:58
In reply to Re: EMSAM-Day 5-Too early??, posted by egas on April 24, 2006, at 22:27:27
I had some bad agitation and anxiety but it has leveled off after two weeks. Now I am just plain old depressed and anxious with stomach aches.
> I have had horrible anxiety and panic after
> 1 week on the patch...took more xanax, still
> trying to hang in there, but feel no better yet
> since I cannot sleep, even when I take the
> patch off at night. I was late for work
> today because I was drugged from Restoril, xanax and seroquel...got some sleep but
> hung over all day and felt lousy...time for
> bed now and still hung over but can't sleep.
> I am about to stop the patch....Best to you!
>
>
>
> > 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 mrporter1 on April 25, 2006, at 2:26:15
In reply to Re: EMSAM-Day 5-Too early??, posted by egas on April 24, 2006, at 22:27:27
Have you tried Rozerem? It's really different and definitely worth looking at...
Posted by RobertDavid on April 25, 2006, at 21:52:39
In reply to Re: EMSAM-Day 5-Too early?? (nm), posted by Crazy Horse on April 25, 2006, at 12:20:19
I have been taking klonopin for 12 years for my social anxiety and now that I'm having good luck with EMSAM (so far) I'm going to start a slow taper off klonopin(.25 drop every 2 weeks). I'm hopefull I'll be able to use EMSAM as mono therapy and get off klonopin.
Though klonopin has been a wonder drug for me and has make me functional over the past decade, it hasn't been perfect and I've always suspected it had a negative effect on mood and mental clarity. EMSAM seems to be eliminating what I don't like about klonopin, but I don't know if it will tackle the social anxiety which is my main issue.
I think starting EMSAM while taking klonopin was probably helpful eliminating side effects for me, but I hope I won't need it any more. I've been wanting to replace klonopin for a long time. We'll see. Rob
Posted by strugglingsteve on April 25, 2006, at 23:39:35
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope, posted by RobertDavid on April 25, 2006, at 21:52:39
Are you sure you want to start a taper now while your body is just getting used to emsam? Are you being impatient about it? My doc always tells me that only one variable at a time. You could have an easy time detoxing or a rough time and you just dont know which you are going to have, so the conservative play dictates one thing and the aggresive risk taking dictates another. If emsam is the magic pill for you, you have the rest of your life to detox off Klonopin. I had a horrendous time getting off of it 4 years ago and am glad I was stable on my AD med. Just my two cents worth.....
> I have been taking klonopin for 12 years for my social anxiety and now that I'm having good luck with EMSAM (so far) I'm going to start a slow taper off klonopin(.25 drop every 2 weeks). I'm hopefull I'll be able to use EMSAM as mono therapy and get off klonopin.
>
> Though klonopin has been a wonder drug for me and has make me functional over the past decade, it hasn't been perfect and I've always suspected it had a negative effect on mood and mental clarity. EMSAM seems to be eliminating what I don't like about klonopin, but I don't know if it will tackle the social anxiety which is my main issue.
>
> I think starting EMSAM while taking klonopin was probably helpful eliminating side effects for me, but I hope I won't need it any more. I've been wanting to replace klonopin for a long time. We'll see. Rob
>
>
Posted by Iansf on April 26, 2006, at 0:05:56
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope » RobertDavid, posted by strugglingsteve on April 25, 2006, at 23:39:35
I agree it's worth waiting awhile to stop the klonopin. And don't overlook the possibility that Emsam and Klonopin together may be what most helps you. Unless the klonopin side effects are simply unbearable - and the fact you've been taking it for 12 years indicates they're not - you should give yourself more time.
> Are you sure you want to start a taper now while your body is just getting used to emsam? Are you being impatient about it? My doc always tells me that only one variable at a time. You could have an easy time detoxing or a rough time and you just dont know which you are going to have, so the conservative play dictates one thing and the aggresive risk taking dictates another. If emsam is the magic pill for you, you have the rest of your life to detox off Klonopin. I had a horrendous time getting off of it 4 years ago and am glad I was stable on my AD med. Just my two cents worth.....
>
>
> > I have been taking klonopin for 12 years for my social anxiety and now that I'm having good luck with EMSAM (so far) I'm going to start a slow taper off klonopin(.25 drop every 2 weeks). I'm hopefull I'll be able to use EMSAM as mono therapy and get off klonopin.
> >
> > Though klonopin has been a wonder drug for me and has make me functional over the past decade, it hasn't been perfect and I've always suspected it had a negative effect on mood and mental clarity. EMSAM seems to be eliminating what I don't like about klonopin, but I don't know if it will tackle the social anxiety which is my main issue.
> >
> > I think starting EMSAM while taking klonopin was probably helpful eliminating side effects for me, but I hope I won't need it any more. I've been wanting to replace klonopin for a long time. We'll see. Rob
> >
> >
>
>
Posted by jetcity10 on April 26, 2006, at 0:45:23
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope, posted by RobertDavid on April 25, 2006, at 21:52:39
Let me know how it goes, as I too am doing the EMSAM/Klonipin combo. I have been wanting to get off of the Klonipin for years but it is the only thing that has allowed me to get some sleep without side-effects the next day (I only get about four hours with the Klonipin, but it was better than nothing). Mine is mainly a philisophical issue because it bothers me that Klonipin is addictive. My doc has said in the past that we will wait a good while before we taper off, but I am interested in what your experience will be.
Posted by ed_uk on April 26, 2006, at 9:53:34
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope » RobertDavid, posted by jetcity10 on April 26, 2006, at 0:45:23
>Mine is mainly a philisophical issue because it bothers me that Klonipin is addictive.
Withdrawal symptoms are common when stopping Klonopin. This is why people say it is addictive. It's quite possible that people will have withdrawal symptoms when coming off Emsam though. Most ADs are associated with withdrawal symptoms, some more than others. Effexor is the most notorious.
Ed
Posted by ttee on April 26, 2006, at 11:43:13
In reply to WD » jetcity10, posted by ed_uk on April 26, 2006, at 9:53:34
Is the anyone NOT on Klonopin that is doing well on Emsam? How can I tell if it is Klonopin or Emsam helps with depression/anxiety?
Posted by zero on April 26, 2006, at 13:18:22
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope, posted by RobertDavid on April 25, 2006, at 21:52:39
I'm with strugglingsteve on this one - one thing at a time, or you won't really know what's doing what.
If it were me (and I hope to try EMSAM if I see that it's helping people w. SP), I'd leave the Klon. in place until I knew for sure the EMSAM was working. Then a very slow taper off of the Klon.
Klon. isn't perfect, but so far, it beats everything else I've tried for SP.
Really hope the EMSAM works for you.
Best wishes,
z.
Posted by RobertDavid on April 26, 2006, at 13:59:52
In reply to Re: EMSAM-3 weeks and getting off klonopin, I hope » RobertDavid, posted by zero on April 26, 2006, at 13:18:22
> I'm with strugglingsteve on this one - one thing at a time, or you won't really know what's doing what.
>
> If it were me (and I hope to try EMSAM if I see that it's helping people w. SP), I'd leave the Klon. in place until I knew for sure the EMSAM was working. Then a very slow taper off of the Klon.
It seems several of you have the same take which seems reasonable, to just stay on klonopin for a while along with EMSAM. But how long do I wait to try to taper down? And how will I know how well EMSAM does for SP if I don't try to taper from klonopin?I recognize I'm being impatient here and even my doctor suggested I stay on klonopin for up to 6 months before trying a taper. He said to wait just so that I could spend a few months feeling good as I never did totally on klonopin alone.
What if I do this, just try to go down to say .25 once a month and see how I do. That would give my body time to continue to adjust to EMSAM while doing an extrememly slow klonopin taper. Since I'm taking 2mgs of klonopin a .25 taper once a month should be so slow that I could deal with it. If I have problems I can just go back to the 2mgs.
Perhaps by doing it this way, such a slow taper that it might be easier vs a quicker taper months down the road. Probably the smart thing to do is just wait, then do a very slow taper. I know I'm being impatient and trying to sell myself on lowering klonopin. I've wanted to find a replacement for a long time.
I also battle with occational drinking binges (about once a month, not daily) which I'm trying to avoid/quit and have heard klonopin/benzo's aren't helpful with because it can keep cravings up not to mention other serious helth issues I'm aware of. I know that's a subject for a different board, but part of my motivation to get off klonopin. Any thoughts on this concept or just continue my 2mgs and wait.
Thanks for your impute. Rob
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