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Dr. Bob is Robert Hsiung, MD,
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Posted by Crazy Horse on April 20, 2006, at 14:56:08
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by RobertDavid on April 20, 2006, at 14:26:20
> Jan:
>
> I so know how you feel. I too have dealt with fear and anxiety. I hate trying new meds, I've had so many side effects without benefits. I've postponed trying an MAOI for 15 years because they just plain scared me. Instead, I wasted a lot of time and put myself through hell trying meds that just didn't work for me.
>
> Everyone here has good points with MAOI's and CBT therapy (which can be good with or without meds in my opinion).
>
> That said, since you're not satisfied with how your doing now and since you haven't had much luck with SSRI's or SNRI's I would say it would make sense and give an MAOI a try.
>
> So assuming you decide to try one, the tough part is picking one, they all work differently for different people. I made my choice based on my doctors recomdation (he knows me well after 15 years). Since I typically feel every side effect he thought EMSAM should be my first try. He felt the side effects would be less than that of SSRI's and possibly other MAOI's, that it could help my problem areas such as lack of energy, motivation, poor moods as well as anxiety SAD and GAD.
>
> And as you know I'm having a terrific response. I just feel better overall, like I'm "normal" for the first time. Perhaps I'd feel the same way if I was on either Parnate or Nardil.
>
> My doc seemed to think that if I was going to try an MAOI and then decide later to switch to another MAOI it would be best to start with EMSAM. For some reason he felt that would be an easier transition than from Nardil to EMSAM or Parnate to EMSAM. That was part of my decision to try EMSAM first. Otherwise he recomended Nardil before Parnate (he uses Parnate with other patients, but for some reason thought for me Nardil would be the better of the two as a first try).
>
> So as you know I chose EMSAM, it was my doctors recomendation and I felt most comfortable with it. I have to say the lack of food restrictions, once a day patch and potential for lack of other negative side effects such as as weight gain and decreased libido (Nardil) entered into my decision. It just seemed to make sense to me.
>
> Sleep is an issue for me, I know it is for you as well. I think staying on valium (I'm on klonopin) will help with that and possibly other initial side effects regardless of your choice. Perhaps in time neither of us will need a benzo blend (which I'm hoping for)if were on the right MAOI. I noticed a few nights during the first week where I slept less, but not insomnia. As time goes on (2 weeks now) I'm sleeping fine.
>
> Those that take Parnate could answer this better than I but it's my understanding Parnate is very activating and good for those with depression, but can cause some insomnia. That Nardil works best for those with anxiety disorters like SAD, but again, I'd defer that to those that take Nardil.
>
> Regardless, If I do fail for some reason on EMSAM, I'd exchange side effects for quality of life now that I've had a taste of it. I'd try all three if I fail on any individual one. Hopefully that won't be the case and EMSAM will continue to be my answer. I certainly know it won't be for everyone and can only post my experience.
>
> I know how stressed you are, confussed what to try, been there done that. Since you seem to have the best comfort level with EMSAM I'd recomend trying it. You're the consumer and if your doctor thinks it's okay, I'd go with it. Even if it's not for you ultimately I doubt you will have any where near the side effects you've probably been through on other meds and as you say you can just take the patch off.
>
> Regarless, I know both of us have read countless stories from others that wish they tried an MAOI years before. Life is passing by fast and I wish it didn't take 49 years for me to try one.
>
> Just my 2 cents worth Jan. I'm thinking about you and hope you give one a try. Like others have suggested, if it doesn't work, you can just stop taking it, but if you don't try you may always wonder. I'd go for it! I think you have something to look forward to......
>
>
> Rob
>
>
>
> Jan,
I would listen to Rob,(no disrespect to gg, she makes a good point as well) He's another who wishes he would have tried an maoi long ago. Counceling is good, but if your brain is not getting the neurotransmitters it needs to function normally, all the counciling in the world won't help. I advise both. I don't think your Luvox is helping you like you would like it to. So a new approach of EMSAM, valium and CBT could be a super fantastic effective combo for you. You deserve to feel well Jan...and if you are an MAOI responder, you will be blown away at how well you feel. :)Love, Monte
Posted by valene on April 20, 2006, at 15:13:14
In reply to Re: ENSAM Patch, parnate or nardil? » willyee, posted by Phillipa on April 20, 2006, at 12:40:05
Hi Phillipa,
I am wondering about the EMSAM also. I seem to be in your age group and also on a benzo as you are, and I have had lots of anxiety. I'm on xanax and reduced it from 3mg to 1.5 - 1.75mg. daily but I think I am having tolerance withdrawal - maybe you have it also from your valium? Just a thought. I also get very anxious about going out especially without my husband. Could we talk?
Via babblemail?
Best regards,
Val> Willyee I've only been on the SSRI's and SSNRI's. Right now you'e all scaring me. Anxiety is my primary symtom but I thought this was good for anxiety too? I'm confused again. Very confused. And no no insurance willing to hit my savings if it would work as I am getting old fast not my fault and I'm sick of the fighting cause I'm afraid to be alone or go anywhere and always complaining of being tired. And having the least little thing increase my anxiety to sthe state of panic. I thought these meds were good for anxiety.? Love Phillipa
Posted by gardenergirl on April 20, 2006, at 15:48:37
In reply to Re: ENSAM Patch, parnate or nardil? » gardenergirl, posted by Phillipa on April 20, 2006, at 14:50:25
> GG didn't you once say that you chose an MAOI first because you wanted to avoid the side effects of the others subtypes of AD's?
Not exactly. I had taken several SSRI's over the years, as well as trying Wellbutrin with an SSRI. None really helped that much. Once I got the diagnosis of atypical depression and learned that MAOI's were the "gold standard" for treatment of this type of depression, I decided to go this route versus try other SSRI's or TCA's.
>And I have an LSW that I just started working with. And she wants to do relaxation theraphy.
That sounds like a good plan. I hope this turns out to be a helpful thing for you.
>Biggest problem is that I have only been in the area since Novemeber so no knows me well. But I can't spend my life on the computer out of fear of the outside world.
It's so hard meeting new friends when you're in a new place, isn't it? Especially as we get older, I think.
Take care,
gg
Posted by linkadge on April 20, 2006, at 17:33:33
In reply to Re: ENSAM Patch, parnate or nardil? » willyee, posted by Phillipa on April 20, 2006, at 12:40:05
The emsam patch never claimed to have anxiolitic properties. While it might help some forms of anxiety, it is far from being concluded as an effective antianxiety/antipanic agent.
You may get more help from nardil in that regard, but even nardil isn't right for everbody.
Linkadge
Posted by linkadge on April 20, 2006, at 17:40:53
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by gardenergirl on April 20, 2006, at 15:48:37
If anxiety and panic attacks are your primary concern then I wouldn't necessarily think that trying emsam is your best next option.
I think that caution is a good thing. I was gung ho to try a MAOI and it ended up with me in a hospital and loosing a semester in school.
Now, this is not really about horror stories, but I think it is a good thing to consider all options.
Linakdge
Posted by Crazy Horse on April 20, 2006, at 18:00:56
In reply to Re: ENSAM Patch, parnate or nardil?, posted by linkadge on April 20, 2006, at 17:40:53
> If anxiety and panic attacks are your primary concern then I wouldn't necessarily think that trying emsam is your best next option.
>
> I think that caution is a good thing. I was gung ho to try a MAOI and it ended up with me in a hospital and loosing a semester in school.
>
> Now, this is not really about horror stories, but I think it is a good thing to consider all options.
>
> Linakdge
>
>
>
Now that you are totally confused and way to afraid to try an maoi, my advice is this Jan-LISTEN TO YOUR DOCTOR! Don't listen to 8 different people telling you completely contradicting stories/opinions. Even though we all mean well and want the best for you, PLEASE LISTEN TO YOUR DOCTOR FIRST AND FOREMOST! And if you don't trust your pdoc, it's time to find another one.
I am sorry if i have confused you Jan...I truly want what's best for YOU!Love, Monte
Posted by Sobriquet Style on April 20, 2006, at 18:02:29
In reply to Re: ENSAM Patch, parnate or nardil? » Sobriquet Style, posted by Phillipa on April 20, 2006, at 11:39:35
>Whaat is pregaabalin?
Pregabalin is the generic name of brand Lyrica. Its a more potent derivative of Gabapentin - Neurontin. There was recently a thread above by SLS about it being approved for generalized anxiety disorder in Europe. I take Neurontin at present and find it effective for general anxiety. I'm happy with the drug all in all. Buut have been keeping my eye on Lyrica for some time as its a stronger substance and very similar to Neurontin. Some reprts at remedyfind.com have said Lyrica has been better than xanax. Some report here have said its been good, some have said its pooped out or not been effective. As i'm a responder of Neurontin I think it would work for me. If you're a person who may respond to the antianxiety effects of Neurontin, its a very safe drug to take with little side effects and some antidepressants effects + mild mood stabilizing. I guess my point is, it can be a good option for anxiety "if" it works. I may try it in the future, at the moment the Neurontin does its job, so if ain't broke etc.
~
Posted by Crazy Horse on April 20, 2006, at 18:13:41
In reply to Re: ENSAM Patch, parnate or nardil? » linkadge, posted by Crazy Horse on April 20, 2006, at 18:00:56
Posted by linkadge on April 20, 2006, at 18:15:33
In reply to Sorry, my above post not intended for Linkadge (nm), posted by Crazy Horse on April 20, 2006, at 18:13:41
No thats cool. Listen to your doctor is good advice, (unless your doctor is my doctor in which case it is not so good advice)
Linkadge
Posted by Crazy Horse on April 20, 2006, at 19:27:52
In reply to Re: Sorry, my above post not intended for Linkadge » Crazy Horse, posted by linkadge on April 20, 2006, at 18:15:33
> No thats cool. Listen to your doctor is good advice, (unless your doctor is my doctor in which case it is not so good advice)
>
> LinkadgeLOL!
Monte
Posted by Phillipa on April 20, 2006, at 19:55:10
In reply to Re: ENSAM Patch, parnate or nardil?, posted by Sobriquet Style on April 20, 2006, at 18:02:29
I've never taken neurotin. Only the benzos and the SSRI's and SSNRI's. Love Phillipa
Posted by Caedmon on April 21, 2006, at 8:40:15
In reply to Re: ENSAM Patch, parnate or nardil? » Sobriquet Style, posted by Phillipa on April 20, 2006, at 19:55:10
Hi Phillipa, here is what I understand about the three, others are welcome to add their input:
EMSAM:
+ Easy, once daily application
+ Energizing, helpful for memory(?)
+ No diet restrictions
+ Motivating antidepressant
- Little research on anxiolytic properties
- Expensive
- New, so some adverse reactions may be underreported
- May cause agitation and insomnia
0 Usually causes slight weight loss
0 Still has the usual drug restrictions
0 Some amphetamine-like qualities
0 Brand-name ("Emsam") sounds much less dorky compared to the other MAOIs :pPARNATE:
+ Very motivating, effective antidepressant
+ Some research as being good for social phobia, panic disorder
+ Easiest to augment?
+ Small doses = easier titration
+ Usually very fast-acting
- May cause agitation and insomnia
- Often requires multiple daily dosing
- Less forgiving of diet restrictions vs. Nardil
0 Usually weight neutral or causes weight loss
0 Some amphetamine-like qualities
0 Sedates some, activates othersNARDIL:
+ LOTS of research shows it helps anxiety
+ More forgiving of diet restrictions vs. Parnate
+ Bonus: good drug for those with high blood pressure
+ Metabolite increases GABA in parts of brain
- May cause major side effects: sexual, weight gain, hypotension
- Least forgiving of drug interactions (?)
- Takes a little longer to kick in vs. other MAOIs
0 Most people either love it or hate it
0 Usually not very activating______________
Maybe that helps in making the decision? I tried to be impartial in my assessment. For me, Parnate had the profile that best matched what I needed so I'm trying that out. Best of luck,- C
Posted by Crazy Horse on April 21, 2006, at 8:52:53
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by Caedmon on April 21, 2006, at 8:40:15
> Hi Phillipa, here is what I understand about the three, others are welcome to add their input:
>
> EMSAM:
> + Easy, once daily application
> + Energizing, helpful for memory(?)
> + No diet restrictions
> + Motivating antidepressant
> - Little research on anxiolytic properties
> - Expensive
> - New, so some adverse reactions may be underreported
> - May cause agitation and insomnia
> 0 Usually causes slight weight loss
> 0 Still has the usual drug restrictions
> 0 Some amphetamine-like qualities
> 0 Brand-name ("Emsam") sounds much less dorky compared to the other MAOIs :p
>
> PARNATE:
> + Very motivating, effective antidepressant
> + Some research as being good for social phobia, panic disorder
> + Easiest to augment?
> + Small doses = easier titration
> + Usually very fast-acting
> - May cause agitation and insomnia
> - Often requires multiple daily dosing
> - Less forgiving of diet restrictions vs. Nardil
> 0 Usually weight neutral or causes weight loss
> 0 Some amphetamine-like qualities
> 0 Sedates some, activates others
>
> NARDIL:
> + LOTS of research shows it helps anxiety
> + More forgiving of diet restrictions vs. Parnate
> + Bonus: good drug for those with high blood pressure
> + Metabolite increases GABA in parts of brain
> - May cause major side effects: sexual, weight gain, hypotension
> - Least forgiving of drug interactions (?)
> - Takes a little longer to kick in vs. other MAOIs
> 0 Most people either love it or hate it
> 0 Usually not very activating
>
> ______________
> Maybe that helps in making the decision? I tried to be impartial in my assessment. For me, Parnate had the profile that best matched what I needed so I'm trying that out. Best of luck,
>
> - CGreat job C! Well, hopefully Parnate will work a long time for me, but if not EMSAM is definitely my next med...dang look at that profile!
Monte
Posted by Sobriquet Style on April 21, 2006, at 13:58:21
In reply to Re: ENSAM Patch, parnate or nardil? » Sobriquet Style, posted by Phillipa on April 20, 2006, at 19:55:10
By all means try the patch or another MAOI and see how things go, and hopefully, you won't need to change and swap.
Remember if it doesn't work, you have Neurontin and Lyrica which can be extreamly good for anxiety if thats your main sympton with mood lifting qualities too and a good nights sleep.
Best of luck.
~
Posted by Phillipa on April 21, 2006, at 20:21:42
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by Caedmon on April 21, 2006, at 8:40:15
You might want to visit this site that was recommended to me I need to do the same. But keep scrolling down til you hit the MAOI's . Thanks guys Love Phillipa
http://www.socialfear.com
Posted by Crazy Horse on April 21, 2006, at 20:55:27
In reply to Re: ENSAM Patch, parnate or nardil?, posted by Phillipa on April 21, 2006, at 20:21:42
> You might want to visit this site that was recommended to me I need to do the same. But keep scrolling down til you hit the MAOI's . Thanks guys Love Phillipa
> http://www.socialfear.com
Please be aware of the fact that this guy is just giving his personal opinion on what has worked for him. He is very dogmatic in his stance for Nardil and is not a doctor or a medical professional of anykind to the very best of my knowledge. Anyone can create a site like he has. This guy used to frequent psycho-babble, and in reading some of his old posts, wasn't doing as well on Nardil as his site now claims he is.-Monte
Posted by Caedmon on April 21, 2006, at 21:50:29
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by Crazy Horse on April 21, 2006, at 20:55:27
> > You might want to visit this site that was recommended to me I need to do the same. But keep scrolling down til you hit the MAOI's . Thanks guys Love Phillipa
> > http://www.socialfear.com
>
>
> Please be aware of the fact that this guy is just giving his personal opinion on what has worked for him. He is very dogmatic in his stance for Nardil and is not a doctor or a medical professional of anykind to the very best of my knowledge. Anyone can create a site like he has. This guy used to frequent psycho-babble, and in reading some of his old posts, wasn't doing as well on Nardil as his site now claims he is.
>
> -MonteHmm, I noticed this too about. He has some archived dr-bob posts. He posted under multiple names, perhaps to inflate responses that he wanted: "chad_3" being the main one. This is my perception anyway, which could be wrong, or a result of misreading.
The website is well-known to me, and I don't agree with everything he writes. He has a lot of unsupported assertions on there.
- C
Posted by Phillipa on April 21, 2006, at 21:59:30
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by Crazy Horse on April 21, 2006, at 20:55:27
Wow Monte thanks for the education would this person be in the achives? What should I look under? Love Phillipa now what have I gottne myself into. Did it again!!!!!!!
Posted by Phillipa on April 21, 2006, at 22:03:32
In reply to Re: ENSAM Patch, parnate or nardil? » Crazy Horse, posted by Caedmon on April 21, 2006, at 21:50:29
Chad_3 going there now. Oh me oh my I'm really sorry guys . Good things I'm not a reasearcher I would be terrible. Sorry Love Phillipa
Posted by Phillipa on April 21, 2006, at 22:16:10
In reply to Re: ENSAM Patch, parnate or nardil?, posted by Phillipa on April 21, 2006, at 22:03:32
Oh my you were right he is an old poster and even had that site in I think 2002 before my time and posted under multiple names. Now what will I be blocked? I better husstle to admin and post an apology to Dr Bob you guys were so right!!!!!!
Posted by ravenstorm on April 21, 2006, at 22:29:00
In reply to Re: ENSAM Patch, parnate or nardil?, posted by Phillipa on April 21, 2006, at 22:16:10
Phillipa, sweetie, you haven't done anything wrong. You are just trying to gather information like the rest of us. Trying to somehow figure out how to get better. It is so very difficult, sometimes, isn't it? Take a deep breath, its all OK.
My thoughts and prayers are with you.
Posted by Phillipa on April 21, 2006, at 23:47:33
In reply to Re: ENSAM Patch, parnate or nardil?, posted by ravenstorm on April 21, 2006, at 22:29:00
Thank-you ravenstorm I was just trying to be helpful. you all opened my eyes. I've always been told I am not street wise. And it's true. Will you all correct me when I'm wrong? My humblest apologies. Love Phillipa
Posted by Crazy Horse on April 22, 2006, at 0:51:30
In reply to Re: ENSAM Patch, parnate or nardil? » Crazy Horse, posted by Phillipa on April 21, 2006, at 21:59:30
> Wow Monte thanks for the education would this person be in the achives? What should I look under? Love Phillipa now what have I gottne myself into. Did it again!!!!!!!
No problem, it's true. Look under MAOI posts by Chad.
Posted by RobertDavid on April 22, 2006, at 1:04:46
In reply to Re: ENSAM Patch, parnate or nardil? » ravenstorm, posted by Phillipa on April 21, 2006, at 23:47:33
> Thank-you ravenstorm I was just trying to be helpful. you all opened my eyes. I've always been told I am not street wise. And it's true. Will you all correct me when I'm wrong? My humblest apologies. Love Phillipa
Jan:
Don't sweat it. You were just trying to be helpful by posting info on the topic. It's clear on the website that it's designed by a guy that is not a doctor, just someone who's battled anxiety and seems to have gone to a lot of trouble to put put a site together. And as it turns out someone that used to babble here. I think there's some useful info on the site, but just like doctors, there's a lot of different takes and disagreements about treatment. And besides, I sent the link to you so your off the hook!Rob
Posted by Caedmon on April 22, 2006, at 11:33:24
In reply to Re: ENSAM Patch, parnate or nardil? » Phillipa, posted by RobertDavid on April 22, 2006, at 1:04:46
It's okay, it's just a website. For what it's worth I've read plenty of articles in peer-reviewed journals that I disagreed with, too.
- C
This is the end of the thread.
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