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Dr. Bob is Robert Hsiung, MD,
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Posted by SFY on June 30, 2006, at 14:42:58
In reply to Re: Who's Still Going Strong with EMSAM? Pulse, posted by helpme on June 30, 2006, at 13:16:27
>
> Seems that there are some serious product design problems with EMSAM. For starters- how about getting it so it actually sticks to skin that moves, wrinkles, and sweats? What did they do, test on immobile office workers in airconditioned locations?
> No wonder it's unpredictable!Sounds like you might have gotten a bum batch of patches. Emsam stays on me in the gym (and I sweat buckets!) and in the shower afterwards.
Posted by SFY on June 30, 2006, at 14:48:25
In reply to Re: Who's Still Going Strong with EMSAM? Pulse, posted by helpme on June 30, 2006, at 13:16:27
Speaking of Emsam's sticking power, I do have one dilemma - namely, the need to rotate the location of the patch. Unfortunately, I have both an excess of body hair on my thighs and chest which preclude me from putting the patch on there. In addition, I have quite a bit of old scar tissue on my back which would likely be a barrier to the transdermal delivery system.
The best and most logical place for the patch is my upper arms which I can alternate from day to day. As I haven't had any rash or other skin reaction I don't see this as a problem but I'm wondering if anyone else sees any potential pitfalls in this approach?
Posted by helpme on June 30, 2006, at 17:13:57
In reply to Re: Who's Still Going Strong with EMSAM? Pulse » helpme, posted by SFY on June 30, 2006, at 14:42:58
As for EMSAM not sticking,
I'm on my third box, so maybe it's just me. I don't have a lot of body hair.
Posted by pulse on July 1, 2006, at 7:41:16
In reply to Re: Who's Still Going Strong with EMSAM? Pulse, posted by helpme on June 30, 2006, at 13:16:27
> Seems that there are some serious product design problems with EMSAM. For starters- how about getting it so it actually sticks to skin that moves, wrinkles, and sweats? What did they do, test on immobile office workers in airconditioned locations?
> No wonder it's unpredictable!ty for the good laugh re: your other post: emsam = glorified scotch tape. yes, unpredictable in this way also, and, i'm sure, not just for you. no way!
not to mention the other infamous stick-ING wicket problem, otherwise known as fumble fingers. at the outrageous price, who wouldn't be nervous upon applying? how many patches or partials i'd lost, i have no clue.
however i DID belatedly learn a *possible* remedy:
just no longer giving a d*mn. then, they go on easily *almost* every time.
pulse
Posted by pulse on July 1, 2006, at 7:51:16
In reply to Another Sticky Emsam Issue, posted by SFY on June 30, 2006, at 14:48:25
soon into my 1st of 4 (or was it 5? lol) failed trials, i put the patch or partial ONLY in the very same locations you are. i had next to no irritation at site, (BUT did have LOTS of redness, dryness + itching was starting on both of my wrists up to elbows).
i have no way of knowing if that would have increased substantially at site location itself -full patch/ 24 hrs - as it has for at least one other here.
pulse
Posted by helpme on July 1, 2006, at 18:27:44
In reply to Re: Another Sticky Emsam Issue » SFY, posted by pulse on July 1, 2006, at 7:51:16
Thanks, Pulse. I think you have a point of "just slapping it on" being helpful. My doc gave me a sample box of 5 at first, and I swear I screwed up each one of those! Just think- a 15$ value apiece! I've gotten better, but the problem is still an issue, and sometimes i just can't figure out why. I'm usually having best luck on my thighs, so I alternate on them, but sometimes, no matter how secure the patch seems in the AM, by later in the day the edges are not quite on right anymore, or the patch is loose, or whatever. I wonder now, if uneven sticking could be a cause of so many of us having unsatisfactory or wildly different results from it? You know, if it is not firmly attached to skin, is medicine not absorbed completely? Of course I only apply on completely dry skin, no lotion- but that doesn't always matter.
Anyone else got tips for making the patch stick?
Posted by Donna Louise on July 1, 2006, at 22:30:02
In reply to Re: Another Sticky Emsam Issue » SFY, posted by pulse on July 1, 2006, at 7:51:16
I tried starting a new thread to get your attention but it didn't show up. This has happened to me before. I tried to babblemail you but missed my window of opportunity. So I wanted you to have my email address.
shoafy@aol.com
Please write.
I hope this gets to you, in the midst of this thread since a new thread is not working.donna
Posted by pulse on July 2, 2006, at 5:56:56
In reply to Pulse!!! Are you here??? » pulse, posted by Donna Louise on July 1, 2006, at 22:30:02
GOT IT and ty so much, donna!
i'm working on an email to you as i write this. it will be coming to your's from a certain 'msprs.'
be well, my friend,
pulse
Posted by Donna Louise on July 2, 2006, at 6:35:27
In reply to Another Sticky Emsam Issue, posted by SFY on June 30, 2006, at 14:48:25
> Speaking of Emsam's sticking power, I do have one dilemma - namely, the need to rotate the location of the patch. Unfortunately, I have both an excess of body hair on my thighs and chest which preclude me from putting the patch on there. In addition, I have quite a bit of old scar tissue on my back which would likely be a barrier to the transdermal delivery system.
>
> The best and most logical place for the patch is my upper arms which I can alternate from day to day. As I haven't had any rash or other skin reaction I don't see this as a problem but I'm wondering if anyone else sees any potential pitfalls in this approach?I had tried different places "all over my body" (where does that come from..some 60's show?) and I find it sticks great and am having no problems at all alternating between one hip and then the other.
Right now I am doing 9mg and 1/2 6mg but when I get to the pdoc next week I will get a regular 12mg patch. That thing should be huge! But no worry, my hips can accomodate that. Not that they are big hips.. there is just alot of room there, no hair and don't bend much. So I just use one side then the other. I move somewhat to the right or left so it is not exactly in the same spot.
That said, emsam has not been all that I had expected but I have unrealistic expectations. It is better than everything else and am trying some stategies (more klonopin, less provigil and adding lamictal) for the weird agitation. I have what I think it was Zeitguest was talking about, same experience. I feel more depression alleviation on 12mg and still don't have a problem sleeping. I know that is rare, makes me think I am just a regular ol' unipolar with some bad anxiety. I am overall satisfied with the minimal side effects of agitiation and irritabilty, the improvement in social anxiety and the energy that I was sorely lacking. I would say it is a success story. I hope that gives hope. Maybe alot of us just need the higher dose. And I am eating tofu without a problem. It is the only thing on the list that I do eat so I dont miss any of the other things. I don't think food is going to be a problem, I think the problem with the higher doses is an increase in contradicted med sensitivity but I don't take any of those other meds anyway either. As long as I can have some morphine, morphine-derivitive for pain, that is fine with me. I don't get colds or allergies so that is a non issue too.
That is enough from me!donna
donna
Posted by Donna Louise on July 2, 2006, at 7:00:52
In reply to Re: Pulse!!! Are you here??? » Donna Louise, posted by pulse on July 2, 2006, at 5:56:56
> GOT IT and ty so much, donna!
>
> i'm working on an email to you as i write this. it will be coming to your's from a certain 'msprs.'
>
> be well, my friend,
> pulseOh whew, I was stressing out about this! I will await your email and then send you the babblemail.
Ok, that is all the off topic I am going to write, Dr Bob!! Just had to make contact and the new thread wouldn't show up.
Thanks,donna
Posted by lisa67 on July 2, 2006, at 11:12:37
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
I have been on Emsam for 2 wks and have mostly postive results. Started w/ cutting the patch in 1/4 then up to 1/2, now full patch 6 mgs. I take it off before bed and sleep great. My side effects are: a little agitated by pm., can't even handle 1 beer. Positve side effects are: energy, motivation, sex drive, and of course depressed thoughts almost all gone. Love it compared to everything else I've tried.
Posted by jealibeanz on July 2, 2006, at 13:54:45
In reply to Re: Who's Still Going Strong with EMSAM?, posted by lisa67 on July 2, 2006, at 11:12:37
Lisa, what else have you tried? Do you have mainly depression or anxiety?
Posted by jealibeanz on July 2, 2006, at 13:57:29
In reply to Re: Another Sticky Emsam Issue » SFY, posted by Donna Louise on July 2, 2006, at 6:35:27
Yeah, that does give some help. Thanks. I wonder if people could be started at 12mg to get the MAOI A involvement. Does it require a titration like the SSRI's?
Posted by lisa67 on July 3, 2006, at 18:19:11
In reply to Re: Who's Still Going Strong with EMSAM?, posted by jealibeanz on July 2, 2006, at 13:54:45
I have tried all the SSRI'S, wellbutrin, effexor and serazone. All had bad side effects, tired all the time, sat on the couch and ate....gained weight, couldn't concentrate and my memory shot. I mostly have depression with some anxiety. I have cut back on caffeine over the past year and my anxiety has greatly improved.
Posted by jealibeanz on July 3, 2006, at 18:49:16
In reply to Re: Who's Still Going Strong with EMSAM?, posted by lisa67 on July 3, 2006, at 18:19:11
Lisa, are you planning on raising the dosage or staying where you are? Did you suggest EMSAM to your pdoc or was it his/her idea?
Posted by jealibeanz on July 4, 2006, at 8:21:10
In reply to Re: Who's Still Going Strong with EMSAM?, posted by jealibeanz on July 3, 2006, at 18:49:16
Does anyone know for sure whether Straterra is contraindicated with EMSAM? I might stop my Straterra anyway, not sure if it helps. But if I do need to stop in order to take an MAOI, I'd like it to be out of my body by the time I see my doctor, in case he decides to go that route.
Posted by 4WD on July 7, 2006, at 12:32:37
In reply to Re: Who's Still Going Strong with EMSAM? Pulse, posted by jealibeanz on June 30, 2006, at 4:38:12
> You think so? I wonder how the drug companies can be thaaaat far off with a medication that's already in use. Maybe the majority of people using aren't expriencing these effects, but it's the people here who are reporting them. Just a thought/hope.
I've been on EMSAM for 11 days now with absolutely no remission of symptoms. I am as depressed , no, more depressed than before I started it. I am on the 6mg patch which I leave on 24 hours.
I am also havin absolutely no side effects. I thought it was supposed to be stimulant. Well, I am exhausted. No energy at all. And no insomnia, either. I fall asleep fine. Actually my sleep is a bit restless but that's all. I had a few mild GI effects at first, little nausea and heartburn but that's gone.
As far as I can tell it is doing nothing at all.
I have been on everything else except traditional MAOIs and so I think this is the end of the road for me. There is nothing left to try and no hope for me. I am ready to go.
Marsha
Posted by 4WD on July 7, 2006, at 12:39:54
In reply to EMSAM doing nothing, posted by 4WD on July 7, 2006, at 12:32:37
> > You think so? I wonder how the drug companies can be thaaaat far off with a medication that's already in use. Maybe the majority of people using aren't expriencing these effects, but it's the people here who are reporting them. Just a thought/hope.
>
> I've been on EMSAM for 11 days now with absolutely no remission of symptoms. I am as depressed , no, more depressed than before I started it. I am on the 6mg patch which I leave on 24 hours.
>
> I am also havin absolutely no side effects. I thought it was supposed to be stimulant. Well, I am exhausted. No energy at all. And no insomnia, either. I fall asleep fine. Actually my sleep is a bit restless but that's all. I had a few mild GI effects at first, little nausea and heartburn but that's gone.
>
> As far as I can tell it is doing nothing at all.
>
> I have been on everything else except traditional MAOIs and so I think this is the end of the road for me. There is nothing left to try and no hope for me. I am ready to go.
>
> MarshaI forgot to say the one good thing about this is that since going off Celexa in order to start EMSAM, my anxiety has more or less disappeared and the pain in my neck and shoulders is much less. My husband asks me which is worse, the fear/anxiety or the depression. I say, would you rather have your right leg cut off, or your left?
M
Posted by Donna Louise on July 7, 2006, at 13:33:22
In reply to Re: EMSAM doing nothing, posted by 4WD on July 7, 2006, at 12:39:54
> > > You think so? I wonder how the drug companies can be thaaaat far off with a medication that's already in use. Maybe the majority of people using aren't expriencing these effects, but it's the people here who are reporting them. Just a thought/hope.
> >
> > I've been on EMSAM for 11 days now with absolutely no remission of symptoms. I am as depressed , no, more depressed than before I started it. I am on the 6mg patch which I leave on 24 hours.
> >
> > I am also havin absolutely no side effects. I thought it was supposed to be stimulant. Well, I am exhausted. No energy at all. And no insomnia, either. I fall asleep fine. Actually my sleep is a bit restless but that's all. I had a few mild GI effects at first, little nausea and heartburn but that's gone.
> >
> > As far as I can tell it is doing nothing at all.
> >
> > I have been on everything else except traditional MAOIs and so I think this is the end of the road for me. There is nothing left to try and no hope for me. I am ready to go.
> >
> > Marsha
>
> I forgot to say the one good thing about this is that since going off Celexa in order to start EMSAM, my anxiety has more or less disappeared and the pain in my neck and shoulders is much less. My husband asks me which is worse, the fear/anxiety or the depression. I say, would you rather have your right leg cut off, or your left?
>
> M
>Marsha, you aren't ready to go, you still have your sense of humor!! That is a great answer, I get asked that all the time, now I know the perfect thing to say.
I hope you will give the patch a fighting chance. It takes awhile to work and I have had to go to 12mg before it is what I need it to be. I got some relief with the 6mg, more with the 9mg and right now I am pretty happy with the 12mg. so you might need more dosage, you definately need more time. So don't leave yet!donna
Posted by 4WD on July 7, 2006, at 18:04:36
In reply to Re: EMSAM doing nothing » 4WD, posted by Donna Louise on July 7, 2006, at 13:33:22
> > > > You think so? I wonder how the drug companies can be thaaaat far off with a medication that's already in use. Maybe the majority of people using aren't expriencing these effects, but it's the people here who are reporting them. Just a thought/hope.
> > >
> > > I've been on EMSAM for 11 days now with absolutely no remission of symptoms. I am as depressed , no, more depressed than before I started it. I am on the 6mg patch which I leave on 24 hours.
> > >
> > > I am also havin absolutely no side effects. I thought it was supposed to be stimulant. Well, I am exhausted. No energy at all. And no insomnia, either. I fall asleep fine. Actually my sleep is a bit restless but that's all. I had a few mild GI effects at first, little nausea and heartburn but that's gone.
> > >
> > > As far as I can tell it is doing nothing at all.
> > >
> > > I have been on everything else except traditional MAOIs and so I think this is the end of the road for me. There is nothing left to try and no hope for me. I am ready to go.
> > >
> > > Marsha
> >
> > I forgot to say the one good thing about this is that since going off Celexa in order to start EMSAM, my anxiety has more or less disappeared and the pain in my neck and shoulders is much less. My husband asks me which is worse, the fear/anxiety or the depression. I say, would you rather have your right leg cut off, or your left?
> >
> > M
> >
>
> Marsha, you aren't ready to go, you still have your sense of humor!! That is a great answer, I get asked that all the time, now I know the perfect thing to say.
> I hope you will give the patch a fighting chance. It takes awhile to work and I have had to go to 12mg before it is what I need it to be. I got some relief with the 6mg, more with the 9mg and right now I am pretty happy with the 12mg. so you might need more dosage, you definately need more time. So don't leave yet!
>
> donna
Hi Donna,Thanks for answering. I don't know what I'd do without this board (tho I haven"t been here much in the last months _ too depressed to care). My pdoc has given me the ok to go to 9mg in two days. I will use one and a half patches of the 6 mg that I have.
In the meantime I will take some Zyprexa to keep myself out of the suicide pit. It's really a miracle drug for me - 5mg at night and for the next 3-4 days I feel better. Unfortunately, I'm a recovering bulimic and when I take Zyprexa, I'm once again an active bulimic. It really triggers the eating disorder.
Is the diet difficult for you?
Marsha
Posted by jealibeanz on July 7, 2006, at 19:22:00
In reply to Re: EMSAM doing nothing » Donna Louise, posted by 4WD on July 7, 2006, at 18:04:36
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?
Posted by Phillipa on July 7, 2006, at 21:17:01
In reply to Re: EMSAM doing nothing » Donna Louise, posted by 4WD on July 7, 2006, at 18:04:36
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
Posted by 4WD on July 7, 2006, at 21:32:46
In reply to Re: EMSAM doing nothing, posted by jealibeanz on July 7, 2006, at 19:22:00
> 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
Posted by Jakeman on July 7, 2006, at 23:13:28
In reply to Re: EMSAM doing nothing » jealibeanz, posted by 4WD on July 7, 2006, at 21:32:46
> > 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.
>
> MarshaMarsha it sounds like you are in the same boat with a lot of us here.
warm regards, Jake
Posted by Donna Louise on July 7, 2006, at 23:14:05
In reply to Re: EMSAM doing nothing » Donna Louise, posted by 4WD on July 7, 2006, at 18:04:36
> > > > > You think so? I wonder how the drug companies can be thaaaat far off with a medication that's already in use. Maybe the majority of people using aren't expriencing these effects, but it's the people here who are reporting them. Just a thought/hope.
> > > >
> > > > I've been on EMSAM for 11 days now with absolutely no remission of symptoms. I am as depressed , no, more depressed than before I started it. I am on the 6mg patch which I leave on 24 hours.
> > > >
> > > > I am also havin absolutely no side effects. I thought it was supposed to be stimulant. Well, I am exhausted. No energy at all. And no insomnia, either. I fall asleep fine. Actually my sleep is a bit restless but that's all. I had a few mild GI effects at first, little nausea and heartburn but that's gone.
> > > >
> > > > As far as I can tell it is doing nothing at all.
> > > >
> > > > I have been on everything else except traditional MAOIs and so I think this is the end of the road for me. There is nothing left to try and no hope for me. I am ready to go.
> > > >
> > > > Marsha
> > >
> > > I forgot to say the one good thing about this is that since going off Celexa in order to start EMSAM, my anxiety has more or less disappeared and the pain in my neck and shoulders is much less. My husband asks me which is worse, the fear/anxiety or the depression. I say, would you rather have your right leg cut off, or your left?
> > >
> > > M
> > >
> >
> > Marsha, you aren't ready to go, you still have your sense of humor!! That is a great answer, I get asked that all the time, now I know the perfect thing to say.
> > I hope you will give the patch a fighting chance. It takes awhile to work and I have had to go to 12mg before it is what I need it to be. I got some relief with the 6mg, more with the 9mg and right now I am pretty happy with the 12mg. so you might need more dosage, you definately need more time. So don't leave yet!
> >
> > donna
>
>
> Hi Donna,
>
> Thanks for answering. I don't know what I'd do without this board (tho I haven"t been here much in the last months _ too depressed to care). My pdoc has given me the ok to go to 9mg in two days. I will use one and a half patches of the 6 mg that I have.
>
> In the meantime I will take some Zyprexa to keep myself out of the suicide pit. It's really a miracle drug for me - 5mg at night and for the next 3-4 days I feel better. Unfortunately, I'm a recovering bulimic and when I take Zyprexa, I'm once again an active bulimic. It really triggers the eating disorder.
>
> Is the diet difficult for you?
>
> Marsha
>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
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