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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 54. Go back in thread:
Posted by RobertDavid on February 28, 2006, at 15:24:08
In reply to Re: FDA approves EMSAM, posted by Psyc 1 on February 28, 2006, at 14:07:11
Bristol Myers said it would be available in 1 to 2 months, we'll see.
Posted by ed_uk on February 28, 2006, at 15:40:24
In reply to Re: FDA Approves EMSAM, posted by RetiredYoung on February 28, 2006, at 15:07:32
What medication are you on?
Ed
Posted by linkadge on February 28, 2006, at 16:19:58
In reply to Link-, posted by bipolarspectrum on February 28, 2006, at 14:43:46
Can a Canadian drug company be billed for an american drug ?
Linkadge
Posted by linkadge on February 28, 2006, at 16:21:40
In reply to Re: FDA Approves EMSAM » RetiredYoung, posted by ed_uk on February 28, 2006, at 15:40:24
If your current medications are not working and Ensam potentially offered more benefit, then I would go through the withdrawl.
Linkadge
Posted by bipolarspectrum on February 28, 2006, at 16:58:04
In reply to Re: Link- » bipolarspectrum, posted by linkadge on February 28, 2006, at 16:19:58
> Can a Canadian drug company be billed for an american drug ?
>
> LinkadgeHey Link,
I'm not sure I understand your question... for emsam to be available in canada, i believe, it would need a canadian distributor which is most likely a subsidiary of a larger american company... when i was getting american drugs like geodon i had to pay the american fee, which was very steep... and if u have some sort of insurance plan, im almost positive it doesnt cover purchasing american drugs.. u have another option for obtaining an american drug beside going across the border... you and ur pdoc could go through the paperwork and have the drug sent in as special status.. but that would take lots time because of the tons of beaucracy to go through... however, ur insurance company would most likely cover the drug via this method i believe...
bps
Posted by gibber on February 28, 2006, at 18:14:15
In reply to FDA Approves EMSAM, posted by jrbecker on February 28, 2006, at 8:11:40
Posted by gibber on February 28, 2006, at 18:18:33
In reply to FDA Approves EMSAM, posted by jrbecker on February 28, 2006, at 8:11:40
I thought the dosages were 20,40,60 mg/day. It seems that they are 6,9, and 12mg/day...I'm sure this is not a last minute change. I suppose 6mg of transdermal is like 20mg of oral tabs. Am I right?
Posted by RetiredYoung on February 28, 2006, at 18:33:05
In reply to Re: FDA Approves EMSAM » RetiredYoung, posted by ed_uk on February 28, 2006, at 15:40:24
Hi Ed - I'm on Zyprexa 10mg, and am just now transitioning from 40mg Prozac to Paxil. I've tried a couple of times to wean myself from various antidepressants in the past, and hellish and futile would be the best terms to describe the experience.
Jim
Posted by cecilia on February 28, 2006, at 20:45:18
In reply to Re: FDA approves EMSAM » Psyc 1, posted by RobertDavid on February 28, 2006, at 15:24:08
Re food restrictions on higher doses but not lower-this still doesn't make a lot of sense to me because one person can have higher blood levels on a low dose than another person on a high dose. I think they're just covering their you know what and cheese etc are probably safe at any dose, though it probably makes sense to avoid the really high tyramine foods like very aged cheeses even on the low doses. I'll definitely give Emsam a try, but I'm not holding my breath, from what I've read it sounds like its likely to be one of those anxiety increasing, insomnia increasing type drugs. Cecilia
Posted by Phillipa on February 28, 2006, at 20:52:49
In reply to Re: FDA Approves EMSAM » ed_uk, posted by RetiredYoung on February 28, 2006, at 18:33:05
The question is do they work? I know this is a change of subject. But during menopause couldn't take oral hormones but had no problem with the creams you appled to your skin. Maybe Ensam is the same? Fondly, Phillipa
Posted by FredPotter on February 28, 2006, at 21:34:25
In reply to Re: FDA approves EMSAM, posted by cecilia on February 28, 2006, at 20:45:18
The killer blow is having to give up broad-bean pods (just kidding)
Posted by jrbecker on February 28, 2006, at 21:39:13
In reply to Re: FDA Approves EMSAM... dosage?, posted by gibber on February 28, 2006, at 18:18:33
> I thought the dosages were 20,40,60 mg/day. It seems that they are 6,9, and 12mg/day...I'm sure this is not a last minute change. I suppose 6mg of transdermal is like 20mg of oral tabs. Am I right?
Actually there's really no difference than those dosages done in the clinical trials (20, 30, 40). I guess they're now measuring transdermal dose absorption [time] rate versus before they spoke of it in terms of dosage by patch area... ...see link above for the product's prescription information/product insert. The following quote from it might explain the discrepancy..."EMSAM systems are transdermal patches that contain 1mg of selegiline per cm2 and deliver
approximately 0.3mg of selegiline per cm2 over 24 hours. EMSAM systems are available in three sizes: 20mg/20cm2, 30mg/30cm2, and 40mg/40cm2 that deliver, on average, doses of 6mg, 9mg or 12mg, respectively, of selegiline over 24 hours."
Posted by aabag on March 1, 2006, at 0:58:46
In reply to Re: FDA Approves EMSAM... dosage? » gibber, posted by jrbecker on February 28, 2006, at 21:39:13
I know I'll certainly be read to try it when April rolls around. The reduction in side effects, and the different mechanism of action over largely "lateral move" antidepressants are two reasons to consider EMSAM.
Posted by blueberry on March 1, 2006, at 5:40:17
In reply to FDA Approves EMSAM, posted by jrbecker on February 28, 2006, at 8:11:40
I couldn't quite get it exactly, I was wondering if anyone knew if 6mg ensam is both MAOI-A and MAOI-B. I know at 6mg regular deprenyl would be just MAOI-B. ???
Posted by Last Chance on March 1, 2006, at 10:45:08
In reply to Re: FDA approves EMSAM, posted by FredPotter on February 28, 2006, at 21:34:25
> The killer blow is having to give up broad-bean pods (just kidding)
Yeah, Fava Beans and a Nice Chianti. I am still putting some faith in Emsam, and am waiting for it to be available. I tried oral Selegeline for awhile with no good results - also moclobomide, which within a week gave me negative sexual side effects which it is not supposed to do. Richard
Posted by Chairman_MAO on March 1, 2006, at 11:49:24
In reply to Re: MAOI-A and MAOI-B at 6mg?, posted by blueberry on March 1, 2006, at 5:40:17
The bioavailability of oral selegiline is poor. Much of it is eliminated by first-pass metabolism in the liver. Some of it binds to MAO-A in the gut.
With the patch, a majority of what gets into the bloodstream makes it to the CNS. The brain:gut ratio of MAO-A inhibition by selegiline patch in guinea pig is 7.5:1.
Posted by Larry Hoover on March 1, 2006, at 12:05:20
In reply to Re: FDA approves EMSAM, posted by cecilia on February 28, 2006, at 20:45:18
> Re food restrictions on higher doses but not lower-this still doesn't make a lot of sense to me because one person can have higher blood levels on a low dose than another person on a high dose. I think they're just covering their you know what and cheese etc are probably safe at any dose, though it probably makes sense to avoid the really high tyramine foods like very aged cheeses even on the low doses. I'll definitely give Emsam a try, but I'm not holding my breath, from what I've read it sounds like its likely to be one of those anxiety increasing, insomnia increasing type drugs. Cecilia
The recommendations about tyramine restriction are statistical concepts. Individuals would be foolish to pay no regard to tyramine, even if on lower doses of Emsam. It is important to determine one's own tyramine sensitivity, whenever overt manipulation of MAO activity is considered, whatever the dose.
Lar
Posted by RetiredYoung on March 1, 2006, at 12:45:52
In reply to Re: FDA Approves EMSAM » RetiredYoung, posted by Phillipa on February 28, 2006, at 20:52:49
>> The question is do they work?
I assume you mean my Zyprexa/SSRI combo? To a degree. They keep me from feeling rock bottom/suicidal, but I never come close to feeling well.
Posted by cecilia on March 1, 2006, at 17:30:07
In reply to Re: FDA approves EMSAM » cecilia, posted by Larry Hoover on March 1, 2006, at 12:05:20
You're probably right Larry. I suspect there will be some big time lawsuits with people who happen to be unusually sensitive to tyramine and it will end up being taken off the market like so many new drugs. I'll be cautious at 1st. Cecilia
Posted by cecilia on March 1, 2006, at 17:31:42
In reply to Re: FDA approves EMSAM, posted by Last Chance on March 1, 2006, at 10:45:08
Don't forget the banana peels-such deprivation. Cecilia
Posted by Phillipa on March 1, 2006, at 18:19:46
In reply to Re: FDA Approves EMSAM » Phillipa, posted by RetiredYoung on March 1, 2006, at 12:45:52
Yes that's what I meant. thank, Phillipa
Posted by Jakeman on March 1, 2006, at 21:03:04
In reply to Re: FDA's decision on EMSAM tomorrow » Jakeman, posted by RobertDavid on February 27, 2006, at 23:15:31
Posted by Iansf on March 2, 2006, at 14:58:59
In reply to Re: FDA approves EMSAM, posted by Last Chance on March 1, 2006, at 10:45:08
<I tried oral Selegeline for awhile with no good results - also moclobomide, which within a week gave me negative sexual side effects which it is not supposed to do. Richard >
Same for me with sexual side effects. I'd heard it could even boost sexual performance, but no such luck. That's my big concern with the patch - will it TRULY not have negative sexual side effects?
Posted by rvanson on March 4, 2006, at 21:16:53
In reply to Re: FDA's decision on EMSAM tomorrow » RobertDavid, posted by Jakeman on February 27, 2006, at 20:48:17
> Can someone summarize what the benefits will be from taking selegline transdermally rather than orally?
>
> thank, JakeIt avoids first pass liver problems, unlike nardil, ect leading to less problems/SE's.
Posted by RobertDavid on March 4, 2006, at 21:21:01
In reply to Re: FDA's decision on EMSAM tomorrow, posted by rvanson on March 4, 2006, at 21:16:53
Getting my perscription for EMSAM Thursday. I'm told it should be available in a few weeks. I'll post how I do.
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