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Dr. Bob is Robert Hsiung, MD,
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Posted by UgottaHaveHope on April 14, 2007, at 1:03:23
In reply to Re: EMSAM - First Day, posted by Shortstop on April 12, 2007, at 11:00:31
I took Emsam for three months for GAD. It seemed to helped a but, but gave me extra energy, which in turn did not help my anxiety. However, it did appear to lift my mood out of the blue around 6-7 weeks.
I took 4mg of Seroquel and 100-150 of Seroquel to counter out the extra energy. I would say I felt like a 6 on scale of 1-10, I only switched to Nardil to go for a 10. I may only hit a 1, but Ill never know unless I try.
E me if you have Emsam Qs, Michael
Posted by Psychobabbler on July 19, 2007, at 16:02:23
In reply to Re: EMSAM - First Day » Sarah T., posted by RobertDavid on April 8, 2006, at 20:31:49
I am about to start using the EMSAM patch. I just called BMS and was told that participants in the clinical trials did not remove the patch for showers or swimming.
> > I was also wondering about getting the patch wet. What about taking a shower or going swimming? Can you take the patch off and put the same one back on?
>
> It's my understanding that the issue with the patch is primarily when it gets hot, such as in a jacuzzi or say if you put a heat pad on it as when it get's hot it may deliver the selegiline quicker.
>
> I don't think getting it wet is and issue such as a normal shower or swimming. I didn't read that anywhere or hear it from my doctor. And from seeing how good it sticks to the skin I doubt any water would get under it. I suppose I could call BMS customer service and find out, probably should.
>
> I don't think they recomend taking it off and putting it back on, probably affects the delivery, not sure.
>
>
>
Posted by crazy777girl on July 19, 2007, at 16:23:17
In reply to Re: EMSAM - First Day » RobertDavid, posted by Psychobabbler on July 19, 2007, at 16:02:23
I could not reposition the patch AT ALL.
My experience was that if I botched the initial positioning - I ruined an entire patch. Thank God for Rx insurance - at that time.
I must admit to not much showering, at that time in my illness, but EMSAM was not effective for me anyway. Strange side effects that were non-tolerable.
Best wishes,
A> I am about to start using the EMSAM patch. I just called BMS and was told that participants in the clinical trials did not remove the patch for showers or swimming.
>
> > > I was also wondering about getting the patch wet. What about taking a shower or going swimming? Can you take the patch off and put the same one back on?
> >
> > It's my understanding that the issue with the patch is primarily when it gets hot, such as in a jacuzzi or say if you put a heat pad on it as when it get's hot it may deliver the selegiline quicker.
> >
> > I don't think getting it wet is and issue such as a normal shower or swimming. I didn't read that anywhere or hear it from my doctor. And from seeing how good it sticks to the skin I doubt any water would get under it. I suppose I could call BMS customer service and find out, probably should.
> >
> > I don't think they recomend taking it off and putting it back on, probably affects the delivery, not sure.
> >
> >
> >
>
>
Posted by Robert David on July 19, 2007, at 23:23:58
In reply to Re: EMSAM - First Day » RobertDavid, posted by Psychobabbler on July 19, 2007, at 16:02:23
Though I no longer take EMSAM I had no issues with showering or swimming with it on. Before doing so I checked in with my psychiatrist who told me it would have little affect on how it would work. If you're asking I would just go about my normal routine and not worry about showering or bathing. Best of luck to you...
Posted by headcheese01 on July 19, 2007, at 23:33:54
In reply to Re: EMSAM - First Day » Psychobabbler, posted by Robert David on July 19, 2007, at 23:23:58
Robert David,
If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?
Thanks.
>>> Though I no longer take EMSAM I had no issues with showering or swimming with it on. Before doing so I checked in with my psychiatrist who told me it would have little affect on how it would work. If you're asking I would just go about my normal routine and not worry about showering or bathing. Best of luck to you...
<<< - Robert David
Posted by Phillipa on July 20, 2007, at 18:58:51
In reply to Re: EMSAM - First Day » Psychobabbler, posted by Robert David on July 19, 2007, at 23:23:58
Rob I feel like a celebrity popped in hope things are great for you. A great person in my opinion. Love Phillipa
Posted by Robert David on July 22, 2007, at 14:01:51
In reply to Re: EMSAM - First Day » Robert David, posted by headcheese01 on July 19, 2007, at 23:33:54
> Robert David,
>
> If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?I tried EMSAM to improve my mood, give me more energy and improve mental clarity. Also, I had hoped it might be a replacement for klonopin to treat SAD, GAD and mild depression (not clinical depression/anxiety related) which disabled me socially for over half my life prior to klonopin.
All other meds I tried as mono therapy or combined with klonopin were a bust for me. All side effects and no benefit.
When I started EMSAM in April 06 I was taking 2mgs klonopin down from 3. I had a very positive initial response to EMSAM. I had a suttle energy boost and sense of improved mental clairty. I was very encouraged.
I started having some slight issues with insomnia, but not enough to get me to stop EMSAM as I have never been a good sleeper. After a while and with my doctors permission I started to do a few things to see if I could improve sleeping.
First I cut the patch in half, basically to try it at a lower dose. I also tied taking it off a few hours before bedtime then back on early in the morning. Both helped.
During the 4 +/- months I was on EMSAM I had the energy to get back to the gym and was exercising more and was overall more motivated at work and feeling better. I improved many areas of my life such as eating better.
One night I took off the patch before bedtime and over the weekend didn't put it back on without noticing much differenceon how I felt. Then it got to be a week. At that point I stopped taking it and have not been back on it since.
While on EMSAM I was able to drop down to 1.5mgs klonopin where I still am today. Klonopin works as well for me now as it did at 3mgs, but with less tiring side effects.
So my overall take on EMSAM is for me it was the best anti depressent I've tried. It really helped give me a boost to get me going again. I don't seem to need anything other than klonopin at this time. I kept my half box of EMSAM and would not hesitate to go back on it again if I slipped back to the way I used to feel.
Though I have not followed the board much since stopping EMSAM I hope there are others that have found it to be helpful.
Posted by headcheese01 on July 23, 2007, at 12:43:54
In reply to Re: EMSAM - First Day » headcheese01, posted by Robert David on July 22, 2007, at 14:01:51
Thanks for the followup, Robert. I appreciate it. I'm glad to hear you're still doing well.
Take care.
Posted by gibber on July 26, 2007, at 23:12:52
In reply to Re: EMSAM - First Day » headcheese01, posted by Robert David on July 22, 2007, at 14:01:51
I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. I took some holidays from Lamictal (a week or two). But I seem to keep coming back. I seem to feel better on it. It has been a long time since I've been to this board. Probably since I started EMSAM. I know it is so hard living for some of you. I have been there before. I would say I'm happy infrequently, but light years from where I used to be. I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. I'm still in CBT. I'm able to hold a rather demanding job and I'm going back to my second semester of music school. Just throwing this out there, because I know many of you need some hope. Let me know if you have any question about anything.
> > Robert David,
> >
> > If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?
>
>
>
> I tried EMSAM to improve my mood, give me more energy and improve mental clarity. Also, I had hoped it might be a replacement for klonopin to treat SAD, GAD and mild depression (not clinical depression/anxiety related) which disabled me socially for over half my life prior to klonopin.
>
> All other meds I tried as mono therapy or combined with klonopin were a bust for me. All side effects and no benefit.
>
> When I started EMSAM in April 06 I was taking 2mgs klonopin down from 3. I had a very positive initial response to EMSAM. I had a suttle energy boost and sense of improved mental clairty. I was very encouraged.
>
> I started having some slight issues with insomnia, but not enough to get me to stop EMSAM as I have never been a good sleeper. After a while and with my doctors permission I started to do a few things to see if I could improve sleeping.
>
> First I cut the patch in half, basically to try it at a lower dose. I also tied taking it off a few hours before bedtime then back on early in the morning. Both helped.
>
> During the 4 +/- months I was on EMSAM I had the energy to get back to the gym and was exercising more and was overall more motivated at work and feeling better. I improved many areas of my life such as eating better.
>
> One night I took off the patch before bedtime and over the weekend didn't put it back on without noticing much differenceon how I felt. Then it got to be a week. At that point I stopped taking it and have not been back on it since.
>
> While on EMSAM I was able to drop down to 1.5mgs klonopin where I still am today. Klonopin works as well for me now as it did at 3mgs, but with less tiring side effects.
>
> So my overall take on EMSAM is for me it was the best anti depressent I've tried. It really helped give me a boost to get me going again. I don't seem to need anything other than klonopin at this time. I kept my half box of EMSAM and would not hesitate to go back on it again if I slipped back to the way I used to feel.
>
> Though I have not followed the board much since stopping EMSAM I hope there are others that have found it to be helpful.
>
>
>
>
>
Posted by headcheese01 on July 27, 2007, at 8:00:10
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
>>>I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. ... I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. ...<<< - Gibber
Hi Gibber,
So, if I read this right, you quit Emsam around 6 months ago, but it had worked for you before, like it did for Robert David?
Just curious, how come you quit it? And when you did take it, were there any side effects that you experienced. I'm new on Emsam myself (8 days). Still figuring out timing of taking the drug, and if the moderate fatigue issues that I get with it will resolve over a couple of weeks, or if that's just the way it will be with Emsam.
I'm a super fast metabolizer, so with all the AD's I ever took, I felt the drug kick in within an hour or so of taking it, and then depending on the drug, I felt something good for a couple to a few (but not more than 4) hours, then I'd crash. Over the years, I had concluded that that experience wasn't worth taking the meds. Yet, I remained by and large depressed... to the point that I actually had VNS implanted. VNS has been a little bit helpful, but not near enough.
So... I finally decided to give an AD another try, and it's Emsam. So far, I'm experiencing similar stuff to what I've experienced with other meds; that is, a couple of hours of feeling good, followed by a couple of hours of moderate fatigue, followed by a few hours of lesser fatigue; then I get really tired and go to bed.
It's all new to me though, so I'll try to give this a good 6 weeks unless side effects become too burdensome.
Posted by jenro on July 27, 2007, at 11:02:11
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
>
what's cbt?
I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. I took some holidays from Lamictal (a week or two). But I seem to keep coming back. I seem to feel better on it. It has been a long time since I've been to this board. Probably since I started EMSAM. I know it is so hard living for some of you. I have been there before. I would say I'm happy infrequently, but light years from where I used to be. I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. I'm still in CBT. I'm able to hold a rather demanding job and I'm going back to my second semester of music school. Just throwing this out there, because I know many of you need some hope. Let me know if you have any question about anything.
>
> > > Robert David,
> > >
> > > If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?
> >
> >
> >
> > I tried EMSAM to improve my mood, give me more energy and improve mental clarity. Also, I had hoped it might be a replacement for klonopin to treat SAD, GAD and mild depression (not clinical depression/anxiety related) which disabled me socially for over half my life prior to klonopin.
> >
> > All other meds I tried as mono therapy or combined with klonopin were a bust for me. All side effects and no benefit.
> >
> > When I started EMSAM in April 06 I was taking 2mgs klonopin down from 3. I had a very positive initial response to EMSAM. I had a suttle energy boost and sense of improved mental clairty. I was very encouraged.
> >
> > I started having some slight issues with insomnia, but not enough to get me to stop EMSAM as I have never been a good sleeper. After a while and with my doctors permission I started to do a few things to see if I could improve sleeping.
> >
> > First I cut the patch in half, basically to try it at a lower dose. I also tied taking it off a few hours before bedtime then back on early in the morning. Both helped.
> >
> > During the 4 +/- months I was on EMSAM I had the energy to get back to the gym and was exercising more and was overall more motivated at work and feeling better. I improved many areas of my life such as eating better.
> >
> > One night I took off the patch before bedtime and over the weekend didn't put it back on without noticing much differenceon how I felt. Then it got to be a week. At that point I stopped taking it and have not been back on it since.
> >
> > While on EMSAM I was able to drop down to 1.5mgs klonopin where I still am today. Klonopin works as well for me now as it did at 3mgs, but with less tiring side effects.
> >
> > So my overall take on EMSAM is for me it was the best anti depressent I've tried. It really helped give me a boost to get me going again. I don't seem to need anything other than klonopin at this time. I kept my half box of EMSAM and would not hesitate to go back on it again if I slipped back to the way I used to feel.
> >
> > Though I have not followed the board much since stopping EMSAM I hope there are others that have found it to be helpful.
> >
> >
> >
> >
> >
>
>
Posted by Phillipa on July 27, 2007, at 19:16:40
In reply to Re: EMSAM - First Day, posted by jenro on July 27, 2007, at 11:02:11
Wasn't EMSAM released last April? Just asking. Love Phillipa ps could have been May.
Posted by d0pamine on July 31, 2007, at 10:59:25
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
For the record, I was also on EMSAM 12mg for 1.5 years and it was a miracle patch for me. (especially once I figured out that potassium citrate cured the associated insomnia) I quit because of the evening time fatigue that it had started causing me.
Posted by RobertDavid on October 2, 2007, at 0:08:02
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
Went back on EMSAM again today. I've come to realize that the financial stress of business (mortgage business) along with relationship issues have beaten me down. Others have pointed out to me that I'm not myself, drained of energy. I'm depressed and can feel it.
So this morning I cut a 6mg patch into quarters, put one of the quarters on and off to work I went.
I ended up having a much more productive day. My response to EMSAM is as I recall it the first time it tried it over a year ago. I felt sharper and had more energy, no negative side affects (yet).
I'll post more after giving it more time. I'm hopeful I will continue to have a positive response on this low dose and EMSAM will be the crutch I need to get me through this difficult period........
Posted by KayeBaby on October 2, 2007, at 16:31:23
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Sorry that you need it but welcome back!
I have been on Emsam since early this spring and went up to 9 mg a little over a month ago. It is a good med for me with few if any discernable side effects.
Kaye
Posted by Phillipa on October 2, 2007, at 20:25:42
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Rob sent you a babblemail. My favorite person of all time so good to see you back but not under the circumstances. People this is a wonderful person truly believe me All my love Phillipa
Posted by Brody on October 2, 2007, at 22:36:35
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Posted by Breizenby on October 16, 2007, at 14:15:55
In reply to Re: d0pamine - your Emsam story please, posted by lcat10 on March 27, 2007, at 22:50:14
Has anyone haad an allergic reaction to the patch? If so, what did you try next. I LOVED THE PATCH. It worked wonders within two days.
Posted by ramsea on October 17, 2007, at 2:01:32
In reply to Re: Allergic reaction to patch, posted by Breizenby on October 16, 2007, at 14:15:55
hi, over the years i have found that Seleginine helps me very much with depression. Is it the same substance and if it is, is it the same dosage ratio?
I mean, I take about 40 mg of Seleginine and I read that 9 mg is pretty high for Ensame. Does anybody know?ramsea
Posted by KayeBaby on October 17, 2007, at 17:09:35
In reply to Re: relation to seleginine????, posted by ramsea on October 17, 2007, at 2:01:32
It is the same substance but the doasge ratio is a bit hard to figure.
I'm on the 9mg and it says on the package 9mg/24hrs and then also above that it says 30mg. So is the 9mg patch equal to 30mg orally?
Somebody here knows and will answer you.
Kaye
Posted by ramsea on October 18, 2007, at 0:45:24
In reply to Re: relation to seleginine????, posted by KayeBaby on October 17, 2007, at 17:09:35
Posted by psychobot5000 on October 21, 2007, at 21:15:08
In reply to Re: relation to seleginine????, posted by KayeBaby on October 17, 2007, at 17:09:35
I have posted on this subject before, though my figures included guesswork.
Nevertheless, the way it was described to me by someone who was integrally involved with the development of the EMSAM patch is as follows:
EMSAM and selegiline are the same substance. However, you would need a very high dosage of oral selegiline (perhaps 80mg taken orally) to get the same blood-levels of selegiline as you get from a 6mg EMSAM patch worn for 24 hours. The reason is that the patch has a much higher efficiency at getting the drug into your bloodstream. This leads to another difference: much of the selegiline you take orally passes through the liver on its way into the bloodstream. The liver processes much of the dose into other active chemicals: amphetamines, mostly. So with an oral dose, you get the impurity of those amphetamine metabolites also.
In sum, as I understand it, the patch gives higher blood levels of the parent drug, with much lower blood levels of amphetamine metabolites, so there is a modest practical difference between them, though they're the same drug.
Posted by ramsea on October 22, 2007, at 1:25:41
In reply to Re: relation to seleginine????, posted by psychobot5000 on October 21, 2007, at 21:15:08
Posted by War-Face on October 22, 2007, at 13:44:41
In reply to Re: relation to seleginine????, posted by psychobot5000 on October 21, 2007, at 21:15:08
> EMSAM and selegiline are the same substance. However, you would need a very high dosage of oral selegiline (perhaps 80mg taken orally) to get the same blood-levels of selegiline as you get from a 6mg EMSAM patch worn for 24 hours. The reason is that the patch has a much higher efficiency at getting the drug into your bloodstream. This leads to another difference: much of the selegiline you take orally passes through the liver on its way into the bloodstream. The liver processes much of the dose into other active chemicals: amphetamines, mostly. So with an oral dose, you get the impurity of those amphetamine metabolites also.
>
> In sum, as I understand it, the patch gives higher blood levels of the parent drug, with much lower blood levels of amphetamine metabolites, so there is a modest practical difference between them, though they're the same drug.
This is a great response to the question regarding dosing and actual blood level differences between oral and transdermal selegiline. Given the differences in blood levels between the two, I wonder if the dose of selegiline provided by Emsam might be BEYOND the dose recommended to prolong life. It seems that in lab tests, there is a bell curve in dose for maximum longevity of mice: give too little, no increase in life span is seen, give too much, and lifespan actually decreases. Would the blood level of selegiline achieved through a dose equivalent to Emsam 6 mg put lab rats out of the beneficial range on this bell-curve in lab rats? Would this correspond to human longevity?Here is an interview with Dr. Joseph Knoll, who discovered selegiline and also reported on its tendency to increase the life of lab rats to various extents depending on the dose/weight ratio:
http://www.smart-publications.com/articles/MOM-knoll.php
Based on his findings with lab rats, I believe Knoll says that the ideal dose to increase human life is something like 1 to 2 mgs per day, which increases with age.
Then, a study done with dogs found that a MUCH higher dose, equivalent to "77 mg/day for a 170-pound person" increased the life span of dogs. Here is a full quote, with link below (which provides reference to the actual study):
"Although it takes too many years to do lifespan studies on long-lived species, another experiment was conducted on elderly beagle dogs. The dogs were given the equivalent of 77 mg/day for a 170-pound person. 80% of the deprenyl dogs survived to the end of the experiment, whereas only 39% of the placebo dogs survived [*6]."
http://www.benbest.com/lifeext/deprenyl.html
I am very curious as to how the delivery of selegiline might alter Knoll's findings on longevity, which of course was conducted on mice. Any thoughts on this subject?
Posted by Phillipa on October 22, 2007, at 20:42:36
In reply to selegiline dose/delivery and longevity??, posted by War-Face on October 22, 2007, at 13:44:41
Would EMSAM do the same? Phillipa
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