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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 50. This is the beginning of the thread.
Posted by former poster on October 27, 2011, at 3:14:46
I found this site:
http://www.preparemd.com/conditions/emsam-deprenyl-selegiline-depression-neuroprotection/
Posted by floatingbridge on October 27, 2011, at 6:15:31
In reply to Emsam is neuroprotective., posted by former poster on October 27, 2011, at 3:14:46
Are you using emsam yourself?
Posted by Phillipa on October 27, 2011, at 10:55:03
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on October 27, 2011, at 6:15:31
No one ever mentioned in past used in Parkinson's Disease and off label in other. Still as expensive? Phillipa
Posted by floatingbridge on October 27, 2011, at 11:52:09
In reply to Re: Emsam is neuroprotective., posted by Phillipa on October 27, 2011, at 10:55:03
Segiline is often used for Parkinson's. However, I just read some study that retracted much of the assumed benefits of segilene. These studies drive me nuts.
Anyways, am back to the 9mg patch again. Not sure what that translates to oral administration.
Posted by former poster on October 27, 2011, at 12:23:38
In reply to Re: Emsam is neuroprotective. » Phillipa, posted by floatingbridge on October 27, 2011, at 11:52:09
I'm on the 12mg patch now. Still just as expensive as ever. It's a shame when the patch falls off on to the floor 3hrs after putting it on.
I was wondering how the oral selegeline compared to Emsam in neuroprotection, prevention too. Disappointing that we can't find any consistent information.
Posted by floatingbridge on October 27, 2011, at 13:06:15
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by former poster on October 27, 2011, at 12:23:38
Isn't it though? About consistent info.
I had a batch of 9mg patches that fell off very easily. A batch of 12mg that stuck like superglue. For almost $800 a box, they should vacuum seal on IMO. My latest thing is to use alcohol swabs on the site before application, even after a shower. Seems to help.
I was on 12mg and two days ago asked to go back to 9mg. I was near blacking out upon standing with a constant ringing in my ears. Took almost two weeks for that sx to show up.
Hopefully, 9mg will be a good dosage. Have you been on for long?
I hope it is working well for you.
Hey. Do you take it off for bed? I do. Seems to help. Doc says that's the latest from a seminar he attended.
Posted by Phillipa on October 27, 2011, at 20:11:47
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on October 27, 2011, at 13:06:15
$800 a box now? What happened to $500 was when first came out? And now this new symptom? Not good. Love Phillipa
Posted by floatingbridge on October 27, 2011, at 20:33:52
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on October 27, 2011, at 13:06:15
Phillipa, that's what my insurance recipt says. And already the intense dizziness, ringing is receding. So it's o.k. I remember to stand up slowly....
Posted by Phillipa on October 27, 2011, at 21:22:43
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by floatingbridge on October 27, 2011, at 20:33:52
Wow you got great insurance the cost some said when 500 was why emsam didn't become popular. Phillipa
Posted by floatingbridge on October 27, 2011, at 21:52:56
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by Phillipa on October 27, 2011, at 21:22:43
I can see why it's not popular. It's crazy. I don't know why the technology of these patches is so expensive. If it was not for insurance, I would not be using this formulation. When our insurance changes next year, I have no idea what to expect.
I think transdermals in general are fantastic. I hope more are being engineered. The tolerabity is much greater.
Posted by Phillipa on October 27, 2011, at 23:10:08
In reply to Re: Emsam is neuroprotective. » Phillipa, posted by floatingbridge on October 27, 2011, at 21:52:56
FB I also do as you can actually see the med. So if something happens and you take it off visually you know it's gone and a matter of time before gone from system. Phillipa
Posted by former poster on October 27, 2011, at 23:34:03
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on October 27, 2011, at 13:06:15
I have been on 6mg Emsam and 450mg of Bupropion on and off for 1 year. I only started 12mg a week ago. I have tried taking the patch off at bedtime with some success at improving my sleep. I don't notice any difference at 12mg. Putting the patch on right after a morning shower has been my routine. I'll have to try the alcohol..
Posted by floatingbridge on October 28, 2011, at 9:11:10
In reply to Re: Emsam is neuroprotective., posted by former poster on October 27, 2011, at 23:34:03
I noticed the effects of 12mg after two weeks. I think it takes time to accumulate. At first, I thought there was no difference. But there was for me.. You went from 6mg to 12mg? Good luck. I hope this works for you.
Posted by Chairman_MAO on October 31, 2011, at 21:40:00
In reply to Emsam is neuroprotective., posted by former poster on October 27, 2011, at 3:14:46
> I found this site:
>
> http://www.preparemd.com/conditions/emsam-deprenyl-selegiline-depression-neuroprotection/More is not always better. It may well be that low doses of selegiline are better with regard to being neuroprotective.
Posted by floatingbridge on November 2, 2011, at 10:36:33
In reply to Re: Emsam is neuroprotective., posted by former poster on October 27, 2011, at 23:34:03
FP, this link, down towards the bottom, says 12mg patch = 40mg oral if I read that correctly.
Posted by avenarius on November 7, 2011, at 22:14:40
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on November 2, 2011, at 10:36:33
I take 40mg selegiline oral per day. It only comes in 5mg tabs so I take 4 in the morning and 4 in the afternoon. (I just filled a 3 month mail order Rx for 720 pills!)
Anyway, the copay is only $5 per month; I think the 12mg patch would be a $75 copay.
Are the side effects much better with the patch? Constipation is a big problem, and sleep is completely impossible without ambien.
MAOIs are the most effective treatment for me by far but I might give up on them due to the sleep issue... the anhedonia is a factor as well.
Posted by floatingbridge on November 7, 2011, at 22:30:53
In reply to Re: Emsam is neuroprotective., posted by avenarius on November 7, 2011, at 22:14:40
I have not taken segiline orally, so I cannot compare. I am currently not experiencing anhedonia, though I think I am taking the equivalent of 30mg. (The 9mg patch)
I cannot report any sx at the 9mg patch. I seem to have a full range of emotion. The patch at this dose feels transparent. Sleep has always been an issue so I have added gabapentin which seems to work, and if that fails I fall back on tenazepam.
If you can afford the co-pay, I would suggest trying the patch and seeing how it is for you.
The 12mg patch certainly had a more typical (from what I have heard) maoi reaction. Hypotension, the beginnings of food reactions, a sense of lethargy. For me that is.
Don't know if this has been helpful. Maybe someone else will respond as well.
Is the oral working for you (besides the insomnia)? I have been instructed to take my patch before sleep. Apparently my pdoc says this is becoming the new protocol for the patch. It seems to help.
Posted by poser938 on November 9, 2011, at 0:09:17
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by floatingbridge on October 27, 2011, at 20:33:52
is it still "neuroprotective" if it makes you feel like a pile of poop?
Posted by floatingbridge on November 9, 2011, at 0:39:55
In reply to Re: Emsam is neuroprotective., posted by poser938 on November 9, 2011, at 0:09:17
Poser, did it really make you feel bad?
Posted by former poster on November 9, 2011, at 1:34:42
In reply to Re: Emsam is neuroprotective. » poser938, posted by floatingbridge on November 9, 2011, at 0:39:55
I feel like crap on Emsam too. I'm on my 3rd week of the 12mg patch. It's making me lethargic, fatigued and just plain ill. Not to mention sleep is impossible. I don't remember feeling this way on Nardil.
Posted by floatingbridge on November 9, 2011, at 6:43:38
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by former poster on November 9, 2011, at 1:34:42
Former Poster, well, I am sorry, too. I moved back down from 12mg to 9mg. I felt terrible on 12mg. 9mg is working well for me, fingers crossed. I was warned ahead of time not too expect much from emsam however. I guess it has a reputation as not being a very good AD. I think it has taken about two months for me to level out and feel the effect.
Will you go back to Nardil?
Posted by former poster on November 9, 2011, at 10:46:53
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on November 9, 2011, at 6:43:38
Will I go back on Nardil?? I think not. Cymbalta worked almost as good as Nardil for me, so I will chemically castrate myself with it again (an equitable trade) in exchange for sanity.
Posted by floatingbridge on November 9, 2011, at 12:47:23
In reply to Re: Emsam is neuroprotective. » former poster, posted by floatingbridge on November 9, 2011, at 6:43:38
Posted by Phillipa on November 9, 2011, at 17:37:23
In reply to Re: Emsam is neuroprotective. » floatingbridge, posted by former poster on November 9, 2011, at 10:46:53
Cymbalta works as well as Nardil for you? First time I heard someone post this. What doseage as when new 60mg was maximum dose now they dose to 120mg. Phillipa
Posted by former poster on November 9, 2011, at 20:58:22
In reply to Re: Emsam is neuroprotective. » former poster, posted by Phillipa on November 9, 2011, at 17:37:23
I took the 60mg dose Cymbalta combined with Bupropion and Clonazepam which was quite effective. Then took 60mg Cymbalta with 10mg of Dextroamphetamine. The later combo was as effective for social anxiety as Nardil and I never developed a tolerance to the Dex, however I had to stop the Dex because of immigration issues when traveling. I also stopped the Cymbalta because of sexual side effects.
At the time I was on Cymbalta I was told 60mg was the highest dose.
I guess its time to say goodbye willie, forget about sex and just enjoy good mental health. But I know this is an impossible equation because I can't be happy as an eunuch.
I have a relative on Cymbalta 120mg alone and it works like a miracle for his depression/social anxiety.
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