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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 301 to 325 of 431. Go back in thread:
Posted by Donna Louise on May 8, 2006, at 21:21:08
In reply to Re: EMSAM: patch placement, posted by lymom3 on May 8, 2006, at 6:34:59
> I'm only on my 5th day of Emsam, but the first 4 days I put the patch on my breastbone area and the area breastbone area. The patches stuck great. Yesterday I put the patch on the outside part of my arm slightly down from my shoulder and it didn't come off, but it didn't stick as well there so I'm back to the chest area.
>
> No matter where I put it though, I end up with a red rash that lasts 2 days. It stings to remove the patch too, that's for sure, but I'm not giving it up. I've actually started using my treadmill again which is big for me...
I tried your idea of putting it on the breastbone and it is sticking just fine there. I take it off during a hot shower and kind of let the water push it off while I help just a little with the peeling. Maybe that would help your irritation.Donna
Posted by egas on May 9, 2006, at 23:12:09
In reply to Re: EMSAM: patch placement, posted by lymom3 on May 8, 2006, at 6:34:59
According to my doctor, you can use Benedryl cream over the patch while you wear it and
after removal if you still have the rash.best of luck!
> I'm only on my 5th day of Emsam, but the first 4 days I put the patch on my breastbone area and the area breastbone area. The patches stuck great. Yesterday I put the patch on the outside part of my arm slightly down from my shoulder and it didn't come off, but it didn't stick as well there so I'm back to the chest area.
>
> No matter where I put it though, I end up with a red rash that lasts 2 days. It stings to remove the patch too, that's for sure, but I'm not giving it up. I've actually started using my treadmill again which is big for me...
Posted by maggiedelena on May 10, 2006, at 19:55:20
In reply to Re: Emsam, ADD-Anxiety-Dysthemia » spooly, posted by Donna Louise on May 8, 2006, at 6:43:22
I fit the ADD-Anxiety-Dysthemia profile. Though I've also had hypomanias, so it's being called BPII. I also suspect my problems are dopamine-related (because I have restless leg syndrome, which is dopamine-related) and LOVE amphetamine-like drugs, like psuedoephedrine, which are basically dopamine-reuptake-inhibitors. In relatively low doses they make me calm and focused, motivated and happy. But not hypomanic happy. HOWEVER - I hated Wellbutrin. Made me agitated and miserable. (Zoloft -- the first thing I tried -- made me basically numb, tired all the time, and not much less depressed). Lamictal gave me mixed results, ultimately more bad than good, so I quit it. I'll be watching this EMSAM stuff closely...
Posted by jetcity10 on May 12, 2006, at 19:02:29
In reply to Re: EMSAM-Time for next refil » theo, posted by RobertDavid on May 2, 2006, at 18:24:55
I started my fourth week of EMSAM on Wednesday. I was having much more anxiety than normal for the first few weeks, but it has now decreased (to no more than normal levels and perhaps even lower - though I am a bit of a pessimist so maybe it is even better). I have started sleeping better too this past week after several weeks of very poor sleep. This seems to be fairly similar to other people's experiences so far, but I just wanted to share my experience so far. Overall I probably still feel better than I have felt in longer than I can remember. This is the best response I have ever had to any AD and I have been on way too many.
Posted by crazy777girl on May 13, 2006, at 13:07:48
In reply to Re: EMSAM-Time for next refil, posted by jetcity10 on May 12, 2006, at 19:02:29
Greetings. A search for EMSAM side effect info brought me to this board today, and much helpful insight. My diagnosis; treatment resistant depression (bipolar, a rapid cycler but in a major depressive state for quite some time) I have a knowledgable, well-regarded Dr, (psychopharmacologist) but because all we've tried so far has been only marginally successful, I've opted for a VNS implant. When insurance approval finalizes, I'll be implanted. It sounded like Sci-Fi in the beginning, but now sounds about as crazy as the pharmaceutical cocktail I swallow every day & its multitude of side effects, known & unknown. Which brings me back to my original point; I've developed serious leg cramps, more like lower body aching, hips down, actually, like I've run a marathon. Believe me, I haven't. I also had a mystery swelling in my neck that made breathing & swallowing difficult, just short of the need to take a trip to the ER but I did go to my PCP. He ordered an ultrasound, decided it was a cyst that burst. All coinciding w/ the start of my patch. I have no site irritation, other than it hurts like heck pulling them off. I switch off on the upper arm area. Showering is no issue, but if you pull one slightly off or touch it while applying, forget it - it won't stick. I've used surgical tape in that case, since they're so expensive I didn't want to toss it & start over w/ a new patch even though my insurance covers them, currently. I did read (just today) about the possibility of cysts & muscle "stiffness", but these don't seem to be common side effects, and my Dr. didn't expect me to experience any significant side effects. This is so new, however, how can we really know? I have high hopes for this, as my Dr has another pt with TRD who is also using a similar combination of meds, including EMSAM, and it seemed to be the magic bullet for him. Does anyone have more experience with EMSAM use, or its side effects?
Posted by RobertDavid on May 13, 2006, at 13:45:37
In reply to Re: EMSAM-3rd Week Side Effects, posted by crazy777girl on May 13, 2006, at 13:07:48
It's been the majic bullet for me. No side effect issues. I'm going into my 6th week and have never felt better. Though everyone is different, no side effects for me other than improved mood, more energy, not depressed.
Though I suppose it's possible for you to get the side effects you're having from EMSAM, I'd think it's unlikely, most likely unrealated. Even if it is listed as a possible side effect it may have been just something someone experience in the trial that was unrelated to the drug. They have to list every side effect people get whether or not it's related to the medication, the drug companies want to cover their butts.
I hope it works for you! Rob
Posted by Donna Louise on May 13, 2006, at 22:00:19
In reply to Re: EMSAM-3rd Week Side Effects, posted by crazy777girl on May 13, 2006, at 13:07:48
> Greetings. A search for EMSAM side effect info brought me to this board today, and much helpful insight. My diagnosis; treatment resistant depression (bipolar, a rapid cycler but in a major depressive state for quite some time) I have a knowledgable, well-regarded Dr, (psychopharmacologist) but because all we've tried so far has been only marginally successful, I've opted for a VNS implant. When insurance approval finalizes, I'll be implanted. It sounded like Sci-Fi in the beginning, but now sounds about as crazy as the pharmaceutical cocktail I swallow every day & its multitude of side effects, known & unknown. Which brings me back to my original point; I've developed serious leg cramps, more like lower body aching, hips down, actually, like I've run a marathon. Believe me, I haven't. I also had a mystery swelling in my neck that made breathing & swallowing difficult, just short of the need to take a trip to the ER but I did go to my PCP. He ordered an ultrasound, decided it was a cyst that burst. All coinciding w/ the start of my patch. I have no site irritation, other than it hurts like heck pulling them off. I switch off on the upper arm area. Showering is no issue, but if you pull one slightly off or touch it while applying, forget it - it won't stick. I've used surgical tape in that case, since they're so expensive I didn't want to toss it & start over w/ a new patch even though my insurance covers them, currently. I did read (just today) about the possibility of cysts & muscle "stiffness", but these don't seem to be common side effects, and my Dr. didn't expect me to experience any significant side effects. This is so new, however, how can we really know? I have high hopes for this, as my Dr has another pt with TRD who is also using a similar combination of meds, including EMSAM, and it seemed to be the magic bullet for him. Does anyone have more experience with EMSAM use, or its side effects?
The only side effect I can say that I have had is a slightly higher pulse. My BP dropped to normal because it was too high from other meds. I have had no orthostatic hypertension or anything like that. I have had none of the other side effects I have gotten from all the sri's and such. nothing. Not even a site irritation. As Robert said, more than likely what you are having is coincidence but ya just never know about these things I guess anything is possible.
Donna
Posted by spooly on May 14, 2006, at 2:16:15
In reply to Re: Emsam, ADD-Anxiety-Dysthemia, posted by maggiedelena on May 10, 2006, at 19:55:20
That describes me pretty much exactly. I'm not going anywhere near bipolar meds though.
> I fit the ADD-Anxiety-Dysthemia profile. Though I've also had hypomanias, so it's being called BPII. I also suspect my problems are dopamine-related (because I have restless leg syndrome, which is dopamine-related) and LOVE amphetamine-like drugs, like psuedoephedrine, which are basically dopamine-reuptake-inhibitors. In relatively low doses they make me calm and focused, motivated and happy. But not hypomanic happy. HOWEVER - I hated Wellbutrin. Made me agitated and miserable. (Zoloft -- the first thing I tried -- made me basically numb, tired all the time, and not much less depressed). Lamictal gave me mixed results, ultimately more bad than good, so I quit it. I'll be watching this EMSAM stuff closely...
Posted by spooly on May 14, 2006, at 2:24:12
In reply to Re: EMSAM-3rd Week Side Effects » crazy777girl, posted by Donna Louise on May 13, 2006, at 22:00:19
oh yeah that raises a good question. Anyone on EMSAM have high blood pressure? I take a relatively low dose of Avalide for blood pressure (160/100 before medication). It's normalized now but I'm curious if anyones had increased blood pressure as a direct result of EMSAM.
Any hypertensives out there on EMSAM?
Posted by jetcity10 on May 14, 2006, at 10:43:07
In reply to Re: EMSAM-3rd Week Side Effects, posted by crazy777girl on May 13, 2006, at 13:07:48
I am on my fourth week and I have noticed a little muscle "achiness" near the patch placement, but that is it. If I put the patch on my upper arm some times it kind of feels as if I had a flu shot or something. If I put the patch on my lower back I get some lower back pain. I don't notice it when it is on the chest area, so I tend to favor that placement. It is not a big enough deal to cause me to change me mind about EMSAM but at times it is a bit annoying...
Posted by darcan on May 22, 2006, at 19:28:40
In reply to Re: EMSAM-3rd Week Side Effects, posted by spooly on May 14, 2006, at 2:24:12
> oh yeah that raises a good question. Anyone on EMSAM have high blood pressure? I take a relatively low dose of Avalide for blood pressure (160/100 before medication). It's normalized now but I'm curious if anyones had increased blood pressure as a direct result of EMSAM.
>
> Any hypertensives out there on EMSAM?I'm on Toprol and Lisinipril. No change in BP since starting EMSAM 9 days ago, but no improvement in my depression either.
Posted by pederspd on May 23, 2006, at 10:13:20
In reply to Re: EMSAM-3rd Week Side Effects, posted by darcan on May 22, 2006, at 19:28:40
Spoke with my doc the other day about the itching/rash type side effects and using benadryl cream. She said the pharm. reps say no because of the whole thing about not taking cold and decongestions. The recommendation is cortisone or hydrocortisone cream.
I'm not having that as a problem but I am getting bruises, like hickies, a day or two after removing the patches. Is it the way that I'm removing them? Anyone else have that problem? Pat
Posted by SFY on May 23, 2006, at 15:40:29
In reply to Side Effects, posted by pederspd on May 23, 2006, at 10:13:20
> Spoke with my doc the other day about the itching/rash type side effects and using benadryl cream. She said the pharm. reps say no because of the whole thing about not taking cold and decongestions. The recommendation is cortisone or hydrocortisone cream.
There isn't a blanket prohibition on taking cold medications.
From the EMSAM insert: "As with other MAOI’s, EMSAM is contraindicated for use with sympathomimetic amines, including
amphetamines as well as cold products and weight-reducing preparations that contain vasoconstrictors (e.g., pseudoephedrine, phenylephrine, phenylpropanolamine, and ephedrine)."In addition the cough suppressant dextromethorphan, which is found in many cold medications, is also contraindicated.
However, there is no prohibition or adverse reaction listed for diphenhydramine the active ingredient in Benadryl. This is especially true when it is a locally applied topical cream that has little chance of getting into your bloodstream.
Posted by stabb on June 9, 2006, at 22:23:49
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
new to board...just wondering how those who recently started with the patch are doing. there hasn't been many posts of late. all the best to everyone!
Posted by stabb on June 10, 2006, at 1:13:57
In reply to Re: EMSAM - First Day, posted by stabb on June 9, 2006, at 22:23:49
sorry everyone...just read all recent posts
Posted by Donna Louise on June 10, 2006, at 6:42:22
In reply to Re: EMSAM - First Day, posted by stabb on June 9, 2006, at 22:23:49
> new to board...just wondering how those who recently started with the patch are doing. there hasn't been many posts of late. all the best to everyone!
Welcome to the board, Stabb. I hope you are well.
I am not as good as I had hoped to be by now. I have increased the dose to 9mg for about two weeks now. I do have energy which is a great change from fighting or being asleep all the time. I have gotten alot done. But I am still somewhat depressed. The anxiety is better too but not as good as I had hoped. I see the pdoc Wed. and see what she advises. Something more needs to be done I am afraid. It could be I am just in a down type cycle and I will be better any moment. The most upsetting thing to me is I get angry so easily. I big explosion and then it is over. That is what I am like if I am not on medicine and I am afraid tht is what I will be like if the medicine doesn't numb me out. I like that the patch doesn't do that but I am left with these rage attacks and residual depression. sigh.Donna
Posted by stabb on June 10, 2006, at 9:29:31
In reply to Re: EMSAM - First Day » stabb, posted by Donna Louise on June 10, 2006, at 6:42:22
Donna, thank you for your honesty. i have been on a host of ADs over the course of the last ten years with different degees of effectiveness - none really all that great. the best of the bunch have been effexor, cymbalta, and lexapro. each seemed to poop out after a year or so. i am currently taking lexapro -second time around- and mirapex - my doc said it has been helpful in augmenting for those with recurrent depression and anxiety. I have been now on these for a little over a week and really feel like a zombie - just in a fog. the lexapro doesn't seem to help at all after having success the first time and this other drug just seems to cloud everthing up. any suggestions from anyone out there? take care and all the best!
Posted by Donna Louise on June 10, 2006, at 14:35:07
In reply to Re: EMSAM - First Day, posted by stabb on June 10, 2006, at 9:29:31
>
> Donna, thank you for your honesty. i have been on a host of ADs over the course of the last ten years with different degees of effectiveness - none really all that great. the best of the bunch have been effexor, cymbalta, and lexapro. each seemed to poop out after a year or so. i am currently taking lexapro -second time around- and mirapex - my doc said it has been helpful in augmenting for those with recurrent depression and anxiety. I have been now on these for a little over a week and really feel like a zombie - just in a fog. the lexapro doesn't seem to help at all after having success the first time and this other drug just seems to cloud everthing up. any suggestions from anyone out there? take care and all the best!Hey Stabb, I am afraid I sounded so negative about the patch in my earlier post. I am so moody, one minute I am depressed, the next I feel pretty good. I am feeling pretty good now and even when I am not, I am still very hopeful for the patch. It is the best one I have taken since paxil pooped out on my way back in the mid '90's and I have taken a bunch of others with a bunch of augmentation, ad nauseum. So, really, although not perfect, and that is part of my problem, wanting perfection, the patch is still doing good by me.
Donna
Posted by stabb on June 10, 2006, at 14:53:27
In reply to Re: EMSAM - First Day » stabb, posted by Donna Louise on June 10, 2006, at 14:35:07
Donna-
thanks for getting back to me as I am in a pretty anxious state right now....i think it is from the mirapex. sounds like you are headed in the right direction w/the patch. I am hopeful for you.
Posted by Donna Louise on June 11, 2006, at 18:43:56
In reply to Re: EMSAM - First Day, posted by stabb on June 10, 2006, at 14:53:27
> Donna-
> thanks for getting back to me as I am in a pretty anxious state right now....i think it is from the mirapex. sounds like you are headed in the right direction w/the patch. I am hopeful for you.I understand that anxiety, it is very disconcerting to say the least. I, as do others, take klonopin with the patch and it seems to be working pretty good the last I heard. Robert David was having some good results, I have not read the whole board in awhile so I don't know if he has been posting or not but you could read his reports in the archives. Some of us just need a good benzo for the pesky anxiety.
Donna
Posted by ette on July 18, 2006, at 18:03:13
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
Hi. I just started the 9 mg patch three days ago. Previous to that, I was on the 6 mg patch. I've noticed that I'm having a hard time adapting to the 9 mg patch. I've nauseous, dizzy, and very tired. The first night, I had a very difficult time staying awake, and felt extremely dizzy and nauseous. I think I'm slowly adapating to the change in medication. Has anyone experienced these changes when going up in dosage? Thanks.
Posted by mayzee on July 18, 2006, at 22:10:50
In reply to Re: EMSAM - First Day » RobertDavid, posted by ette on July 18, 2006, at 18:03:13
I'm in my 9th day at 9mg (after 7 weeks at 6mg). When I went up in dose I got a resurge in the side effects I'd had when starting: insomnia, GI discomfort, orthostatic hypotension. I have been very tired since the start so that wasn't new. Haven't had any nausea. The past few days I've had a few episodes of feeling spacey, light-headed, not quite dizzy, but a little out-of-it.
But today I feel a little better. Despite lack of sleep, felt more up today and able to get some things done. Dare I hope?
Posted by SLS on July 19, 2006, at 6:08:31
In reply to Re: EMSAM - First Day, posted by mayzee on July 18, 2006, at 22:10:50
Don't let insomnia be the thing that stops you. There are too many ways to treat it.
It can take 3-4 weeks for an antidepressant to work from the time you start the right dosage, so the clock really started 9 days ago. Anything shorter than that is a gift.
Good luck.
- Scott
Posted by Donna Louise on July 19, 2006, at 7:20:31
In reply to Re: EMSAM - First Day » RobertDavid, posted by ette on July 18, 2006, at 18:03:13
> Hi. I just started the 9 mg patch three days ago. Previous to that, I was on the 6 mg patch. I've noticed that I'm having a hard time adapting to the 9 mg patch. I've nauseous, dizzy, and very tired. The first night, I had a very difficult time staying awake, and felt extremely dizzy and nauseous. I think I'm slowly adapating to the change in medication. Has anyone experienced these changes when going up in dosage? Thanks.
I have gone from 6 to 9 and now am on 12mg I guess for about a month, I loose track. Anyway, I have not had any of those side effects and have had none on dosage increase. the higher I go, the less irritable I am which is the only thing that is bothersome. And as Scott said about insomnia, that is no reason to stop it, there are too many ways to treat irritability, Lamicatl doin a good job of that for me. I am getting alot more benefits than the one side effect of irritablity. I hope that gives you some hope.
donna
Posted by mayzee on July 19, 2006, at 8:57:47
In reply to Re: EMSAM - First Day » RobertDavid, posted by ette on July 18, 2006, at 18:03:13
How long were you on the 6mg patch?
Did you have any side effects at 6mg?
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