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Dr. Bob is Robert Hsiung, MD,
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Posted by crazy777girl on July 10, 2006, at 3:43:50
In reply to Re: VNS or Emsam?, posted by t2green01 on July 9, 2006, at 7:44:49
I'm in a similar situation, non-responsive to treatment. I've bombed out w/ Emsam & am on a waitlist currently w/ Cyberonics for an implant. Many on the board here have seemed to benefit from Emsam, though. VNS is last resort - if all else has failed. If that's the case, though - I would strongly encourage you to talk w/ your pdocs & do your research. It may be a viable alternative for improvement. I am hoping it will be. Best of luck, A.
> I have been a disability for 2 years due to anxiety and depression. I have tried every ssri and ect treatment with very little or so success. My doctor wants me to have Vagal nerve stimulation but I could try Emsam if I want to try one more med. I dont know what to do
Posted by Kirkster on July 10, 2006, at 12:19:02
In reply to Re: VNS or Emsam? » t2green01, posted by crazy777girl on July 10, 2006, at 3:43:50
Confused about EmSam -
I was diagnosed as Bipolar Depression (cycle from norm. to depressed) and put on Lithium and Lamictal and doing great until Lithium toxicity (lots of fun!). I went down a bit on Lithium and so did my mood - big time. Now back up halfway on Lithium and not doing too well. Now my doc wants to try Emsam, but the idea of a MAOI is scary to me - been on every SSRI known to man, but not sure about trying Emsam. Is it worth a try or are the side effects so bad I should run away from it.Kirkster
Posted by iamme2 on July 10, 2006, at 14:33:13
In reply to Re: EMSAM doing nothing » jealibeanz, posted by Donna Louise on July 8, 2006, at 7:44:05
Donna,
I noticed in your post that you take lamictal as well as Emsam. I've been given lamictal to try along with Emsam, but doc and I agreed to start with the Emsam first to see how that goes. So far (at about day 11, 6mg patch) it is not working well at all. I feel physically ill (like I have the stomach flu), tired and groggy, and am a raving bitch to those close to me. I'm thinking I should start lamictal sooner rather than later. Can I ask what dosage of lamictal you started with? And, I'm wondering if I just haven't given Emsam enough time to start working. Geez, I just hate feeling so miserable!
Thanks for any help!
M
Posted by jealibeanz on July 10, 2006, at 19:40:56
In reply to Re: EMSAM doing nothing, posted by iamme2 on July 10, 2006, at 14:33:13
Is it possible for you to move up to 12 mg, to see if it help? Or would that be too much of a shock to your body?
Posted by Donna Louise on July 10, 2006, at 20:51:50
In reply to Re: EMSAM doing nothing, posted by iamme2 on July 10, 2006, at 14:33:13
> Donna,
>
> I noticed in your post that you take lamictal as well as Emsam. I've been given lamictal to try along with Emsam, but doc and I agreed to start with the Emsam first to see how that goes. So far (at about day 11, 6mg patch) it is not working well at all. I feel physically ill (like I have the stomach flu), tired and groggy, and am a raving bitch to those close to me. I'm thinking I should start lamictal sooner rather than later. Can I ask what dosage of lamictal you started with? And, I'm wondering if I just haven't given Emsam enough time to start working. Geez, I just hate feeling so miserable!
>
> Thanks for any help!
> MI am sorry you are feeling so lousy. I know exactly how it feels. Especially when you first start a drug you have high hopes for and it fails to meet the expectations. My expectations were way to high, I had waited so long for it..Anywya, no, you haven't given anywhere near enough time. And even after you do give it enough time at 6mg, you may have to go to 9 or 12 and then give that strenght enough time too. I am at 12 and that is working for me.
I did not start the lamictal until I had been on the patch about 6 weeks. It was working pretty good except for alot of irritability. That is the reason for lamictal addition. Which helped almost right away. Later, 6mg was not enough for the depression and neither was 9mg but 12 is good. And with the lamictal no more irritability either. I think both contribute to that.
When you start lamictal you should get a starter pack which has you on 25mg for two weeks, then 50 for two weeks, then 100 for two weeks and then from there you and your dr. decide whether to go higher. Each time you go up, you have to do it slowly or the risk of the Stevenson-Johnson rash gets higher. I have one more day of 50mg then I go to 100mg. I have had no side effects at all, another good reason to start low and go slow.
Try to be patient, I know it is hard because you don't want to be miserable a moment longer but that is just the way it is. And you may be richly rewarded if you don't quit before the fat lady sings...no slight intended to fat ladies. It is just a saying..
Hang in there and good luck.donna
Posted by Donna Louise on July 10, 2006, at 20:56:41
In reply to Emsam, et. al, posted by Kirkster on July 10, 2006, at 12:19:02
> Confused about EmSam -
> I was diagnosed as Bipolar Depression (cycle from norm. to depressed) and put on Lithium and Lamictal and doing great until Lithium toxicity (lots of fun!). I went down a bit on Lithium and so did my mood - big time. Now back up halfway on Lithium and not doing too well. Now my doc wants to try Emsam, but the idea of a MAOI is scary to me - been on every SSRI known to man, but not sure about trying Emsam. Is it worth a try or are the side effects so bad I should run away from it.
>
> KirksterMAOI's can cause a bipolar to have a manic episode as can SSRI;s. Did that happen to you with any one of the SSRI's? If it didn't, maybe you would be ok with an MAOI too.
Everyone is different, you may have no side effects at all. It seems from this board that most reported side effect is insomnia with irritablity a close second. I did not get insomnia and the addition of lamictal and the higher dosage of 12mg took care of the irritablity. So even if you do get a side effect or two, they may of the type that can be managed to where they are not a problem. Guess you won't know unless you try.donna
Posted by Phillipa on July 10, 2006, at 21:12:54
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 10, 2006, at 20:51:50
Donna I am on the starter pack too. Did it make you feel tired, any diarrhea? Headaches? Love Phillipa
Posted by Donna Louise on July 10, 2006, at 21:40:05
In reply to Re: EMSAM doing nothing » Donna Louise, posted by Phillipa on July 10, 2006, at 21:12:54
> Donna I am on the starter pack too. Did it make you feel tired, any diarrhea? Headaches? Love Phillipa
No, no side effects at all.
donna
Posted by iamme2 on July 11, 2006, at 11:12:05
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 10, 2006, at 20:51:50
Donna L.
Thanks so much for your (speedy) reply. I wimped out last night and took off the patch without replacing with a new one. I just could not take another day of feeling like absolute crap (while having to be at work, of course). I need to call the doc and see what he thinks about starting the lamictal and I'll ask about the side effects too. I've taken several SSRI's and have never had such severe reactions to any of them. I've switched to Emsam as all the SSRI's eventually petered out on me. Anyway, I'll put the patch back on tonight and just grit my teeth. I do feel better today without the patch, but I'll bet that's just psychological.
Thanks again,
M
Posted by Donna Louise on July 12, 2006, at 6:56:34
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 11, 2006, at 11:12:05
> Donna L.
>
> Thanks so much for your (speedy) reply. I wimped out last night and took off the patch without replacing with a new one. I just could not take another day of feeling like absolute crap (while having to be at work, of course). I need to call the doc and see what he thinks about starting the lamictal and I'll ask about the side effects too. I've taken several SSRI's and have never had such severe reactions to any of them. I've switched to Emsam as all the SSRI's eventually petered out on me. Anyway, I'll put the patch back on tonight and just grit my teeth. I do feel better today without the patch, but I'll bet that's just psychological.
>
> Thanks again,
> MHey, it is really hard to go to work when you feel so bad. Don't add feeling guilty to your other problems! Who knows, it may not be right for you. We have to just keep plugging along until we get it figured out. I wish you the best of luck with this.
donna
Posted by iamme2 on July 12, 2006, at 11:00:09
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 12, 2006, at 6:56:34
Donna,
After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
Megan
Posted by Donna Louise on July 12, 2006, at 21:52:14
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 12, 2006, at 11:00:09
> Donna,
>
> After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
>
> MeganI imagine if you like the Emsam enough, you can do something else for your BP. With the MAOI's usually low BP is only a problem when you stand up, orthostatic hypotension. My bp is normal.
I don't think lamictal is effective or recommended by itself very often. In unipolar depression, it is taken with AD. In bipolar depression, it is taken with another mood stabilizer. But who knows, maybe it would work for you. You never know unless you try it.donna
Posted by Phillipa on July 12, 2006, at 23:31:48
In reply to Re: EMSAM doing nothing » iamme2, posted by Donna Louise on July 12, 2006, at 21:52:14
Sometimes lamictal is taken without an ad in unipolar depression. Love Phillipa
Posted by jkshrews on July 23, 2006, at 13:35:45
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
I'm going along OK after about 2 months. I'm at the 9 mg dose and intend to move up to 12 next week. I've found the best place to stick the patch and have it stay on for 24 hours is on the back of my shoulder, just over the crest. It has to go somewhere the skin doesn't experience much flexing.
During the drying-out period between stopping Wellbutrin and starting EMSAM, my firbromyalgia symptoms went nuts, but then settled down again after using the patches for a week.
I believe my mood is a bit improved compared to what I was taking before, and I have had a couple of really good days. Since this breaks down into d-amphetamine and methamphetamine, I was hoping for some resulting mood stimulation and some appetite reduction, but that hasn't happened yet. I think there are some sexual side-effects, but it is difficult to distinguish what is from the depression and what is from the drug.
I have experimented around with no-no foods as my dose has increased. So far, there is no problem with anything, but I do keep 50 mg of clorpromazine on me just in case.
I had started treatment for high blood pressure in January, and they wanted to increase the dose of my ACE inhibitor again in April, but I asked not to, since I was intending to start an MAOI, and I was concerned about the "additive hypotensive effect." When I went up to the 9 mg EMSAM patch, sure enough, my blood pressure went down into the normal range. I am wondering if at 12 mg EMSAM I will have to stop the ACE inhibitor.
--------------------------------------------
> I been considering this for months and wanted so badly it to be my next "wonder cure". I'm saddened by all the people who have had to discontinue. Is there anyone still doing well? Please share your story!
Posted by t2green01 on July 25, 2006, at 5:34:15
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
Can I have bottled beer(3-4) on emsam? I start patch 7-26-2006
Posted by SFY on July 25, 2006, at 14:45:52
In reply to Question, posted by t2green01 on July 25, 2006, at 5:34:15
> Can I have bottled beer(3-4) on emsam? I start patch 7-26-2006
On the 6 mg patch there are no diet restrictions. For the 9 mg & 12 mg patches, bottled beer is permitted (but as with all ADs more than moderate alcohol use is discouraged since alcohol is a depressant).
Posted by jkshrews on July 26, 2006, at 8:32:50
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 12, 2006, at 11:00:09
Megan,
Lowering the blood pressure might be the most common side-effect of MAOIs. One is sold as a high blood pressure remedy--I think Eutonyl. But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
jkshrews
> Donna,
>
> After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
>
> Megan
Posted by mayzee on July 26, 2006, at 8:52:13
In reply to Re: EMSAM doing nothing, posted by jkshrews on July 26, 2006, at 8:32:50
> But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
>
> jkshrews
>
Thanks for that suggestion. I am having trouble with low blood pressure caused by Emsam (light-headedness, dizziness, darkened vision, headache, etc.) My doctor suggested drinking lots of water & eating salty foods. I'll go get some salt tablets.Anyone have any other suggestions for dealing with low blood pressure, please let me know.
Thanks!
mayzee
Posted by Donna Louise on July 26, 2006, at 14:47:51
In reply to how to treat Low Blood Pressure caused by Emasam, posted by mayzee on July 26, 2006, at 8:52:13
> > But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
> >
> > jkshrews
> >
>
>
> Thanks for that suggestion. I am having trouble with low blood pressure caused by Emsam (light-headedness, dizziness, darkened vision, headache, etc.) My doctor suggested drinking lots of water & eating salty foods. I'll go get some salt tablets.
>
> Anyone have any other suggestions for dealing with low blood pressure, please let me know.
>
> Thanks!
>
> mayzeeSomthing really weird is happening with my bp. Since starting Emsam, it has been 90 something over 60 something most of time but I have had no bad effects from that. What is weird is, if I go to long without eating, it shoots way up there. Like once when I went almost 9 hours it went to 173/105. (The higher the bp, the lower the pulse btw, and vice versa). Within 30 minutes after eating it starts dropping and within and 1 1/2 hours it is down to its usual low MAOI readings. I have never had this before, that I know of. Maybe I have and just didn't notice because I have never taken my bp several times a day before either. Since I have started since the patch. I wanted to make sure it didn't get to low and instead I discover this weird phenomena. Does anyone know if low blood sugar can cause high bp? It is the only theory I have at the moment and have not had time to research it.
Thanks,
donna
Posted by Phillipa on July 26, 2006, at 20:51:38
In reply to Re: how to treat Low Blood Pressure caused by Emasam » mayzee, posted by Donna Louise on July 26, 2006, at 14:47:51
Donna there's a medical term for this a widening pulse but a technical name. This is not normal and I believe you need to deal with it proptly don't know but don't think it's the med. Call your doc ASAP or the ER and see what they say. Seriously not trying to scare you. Love Phillipa
Posted by Donna Louise on July 27, 2006, at 6:54:52
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Donna Louise, posted by Phillipa on July 26, 2006, at 20:51:38
> Donna there's a medical term for this a widening pulse but a technical name. This is not normal and I believe you need to deal with it proptly don't know but don't think it's the med. Call your doc ASAP or the ER and see what they say. Seriously not trying to scare you. Love Phillipa
Are you speaking specifically about this happening only when you wait too long to eat? And when it is resolved immediately after eating? I would like to know the name of what you mention so I can research it. I have already spoken with my dr.donna
Posted by naughtypuppy on July 27, 2006, at 9:02:21
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Phillipa, posted by Donna Louise on July 27, 2006, at 6:54:52
My pdoc recomended eating a little bit of aged cheese several times a day with Nardil to bring my base bp of 90/50! up to a higher level. Increases Tyramine level. I was hitting the floor several times a day going into convulsions. Still get dizzy, but it seems to help, and I like the cure. Better than another taking another pill!
Posted by t2green01 on July 27, 2006, at 9:15:10
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by naughtypuppy on July 27, 2006, at 9:02:21
that doesnt sound right at all
Posted by hermansmom on July 27, 2006, at 14:29:53
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by t2green01 on July 27, 2006, at 9:15:10
I have recently gone off of cymbalta and have experienced helliosh withdrawal symptoms. I, like many of you have been on virtually every SSRI and have been treatment resistant. I have an anxiety disorder, major depression, and agoraphobia. I saw my pdoc yesterday, and he gave me emsam samples (6mg) and wants me to try it for 2 weeks. I also take clonazepam (klonipin) and Rozarem (sp?) a sleep RX. I gained a gang of weigth on Cymbalta about 60 pounds in 7-8 mos. Since going off it 22 days ago, i have lost 7 lbs (still look like a fat beast, but going down is better than up!) The weight gain has worsened my depression, and social anxiety-frankly, I just feel fat and disgusting and at my wits end!!!I have been off work for 2 years and pdoc has suggested ECT, but I'm scared of that, now, too. The Cymbalta experience (increased suicidal ideation, including hospitalization for suicide attempt, and withdrwal symptoms from hell) has made me reluctant to try yet another guinea pig drug. I am curious about potential psych side effects,as well as weight gain, I already have low BP, and wonder if there are withdrawal effect from this as with Cymbalta. If you google cymbalta withdrwal you'll get an idea of what I mean. I am so scared and so desperate! I know the weight gain thing may just sound like a vanity thing, but it really has put a huge dent in my self image and increased my dpression. I already feel gross and worthless enough.
Posted by t2green01 on July 27, 2006, at 15:40:14
In reply to new to emsa and SCARED!!!!, posted by hermansmom on July 27, 2006, at 14:29:53
Hermansmom.......
My story sounds 110 percent the same as yours. I was very scared to start the Emsam. I have been through all of the ssri's and combos of them. Im a hundred and ten pounds heavier then I was 5 years ago. Since the anxiety and depression has started I just have been existing each day. I havent been a good dad, friend etc etc.... I have been on emsam for 4 days. I was scared to start taking it but I want to live and overcome this crappola. If eating elephants terds cured depression I would... well you know what I'm saying. We do what we have to do and If you scare yourself to death of a med there is pretty much no way it will help in my opinion. You have to believe your condition is going to improve. Damn, I sound like one of those motivational speakers.
I have been pretty pleased with Emsam. Im only 4, almost 5 days into it but I believe it is helping. Keep me updated of how you are doing and I will do the same 4 u .
Here are a couple sites you might like to read:My insurance has approved me for VNS therapy. I have that as a option in the near future.
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