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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by jealibeanz on October 6, 2006, at 10:51:27
OK, I've discussed many times the fact that I'm considering EMSAM, but am still undecided and apprehensive about the insomnia and weight gain that may occur. I know that the company says there's no weight gain, but why would this differ so much from the other MAOI's which can cause weight gain? Plus, recently a few members cited this response, the first I'd ever heard of people gaining. Since my weight gain response to AD's seems over the top, to say the least, I'm always fearful of trying another. Can anyone offer any explainations or reasearch articles to help me out?
Posted by SLS on October 6, 2006, at 11:10:51
In reply to EMSAM/selegiline research articles/statistics..., posted by jealibeanz on October 6, 2006, at 10:51:27
> OK, I've discussed many times the fact that I'm considering EMSAM, but am still undecided and apprehensive about the insomnia and weight gain that may occur. I know that the company says there's no weight gain, but why would this differ so much from the other MAOI's which can cause weight gain?
I think the weight gain is associated with the hydrazines, of which there are only two: Nardil and Marplan. I have not heard it as a consistent side effect with any other MAOI. These drugs probably affect glucose dynamics, but I am not sure how.
Insomnia is part of the deal, I guess. It is a problem in a great many people, and will just have to be treated aggressively using medication or other alternative therapies you feel are effective and safe. I used Ativan when I took Parnate and Nardil. You do what you gotta do. Insomnia is often a good sign for me that a drug is going to work.
- Scott
Posted by jealibeanz on October 6, 2006, at 14:12:58
In reply to Re: EMSAM/selegiline research articles/statistics., posted by SLS on October 6, 2006, at 11:10:51
I'm not terribly worried about anxiety and insomnia as long as my doc is willing to counter them with other meds.
But the weight does bother me. Who knows why I gain on SSRI's, SNRI's, and Wellbutrin. Is it some form of thryoid change? It is the histamine involvement along with Serotonin? Hyperglycemia? Not willing to deal with added weight gain when I'm already not happy. Ughhh.... no fun. :(
Posted by Questionmark on October 6, 2006, at 16:55:09
In reply to Re: EMSAM/selegiline research articles/statistics., posted by jealibeanz on October 6, 2006, at 14:12:58
You are mUch less likely to experience weight gain from selegeline than many other drugs. It is pretty uncommon to gain weight on Wellbutrin, too though, but I do know a couple people who have and it certainly does happen sometimes.
But please don't avoid even trying the drug (EMSAM) due to this fear. If you happen to gain weight you can always discontinue. But I'd be willing to be that you will not-- and I think there's a decent chance you could even lose weight.
Selegeline is a fairly potent catecholamine enhancer, which means that it *should* decrease appetite and probably even raise metabolism somewhat. I make no guarantees, but try it!
:?)
> I'm not terribly worried about anxiety and insomnia as long as my doc is willing to counter them with other meds.
>
>
> But the weight does bother me. Who knows why I gain on SSRI's, SNRI's, and Wellbutrin. Is it some form of thryoid change? It is the histamine involvement along with Serotonin? Hyperglycemia? Not willing to deal with added weight gain when I'm already not happy. Ughhh.... no fun. :(
Posted by jealibeanz on October 6, 2006, at 20:04:49
In reply to Re: EMSAM/selegiline research articles/statistics. » jealibeanz, posted by Questionmark on October 6, 2006, at 16:55:09
I'd just hate to pursuade my doctor into letting me try it and then end up hating it. Everytime I D/C a med I swear I'll never try another because of side effects, yet, my need for help keeps pulling me back toward meds.
Posted by Questionmark on October 6, 2006, at 20:43:50
In reply to Re: EMSAM/selegiline research articles/statistics., posted by jealibeanz on October 6, 2006, at 20:04:49
> I'd just hate to pursuade my doctor into letting me try it and then end up hating it. Everytime I D/C a med I swear I'll never try another because of side effects, yet, my need for help keeps pulling me back toward meds.
I understand.
But if you have reason to think that this one will help, you should really give it a shot.
Posted by Phillipa on October 6, 2006, at 21:35:48
In reply to Re: EMSAM/selegiline research articles/statistics., posted by Questionmark on October 6, 2006, at 20:43:50
A lot of us thought that EMSAM was the wonder drug that you just put a patch on your skin. And you could see it. And if the side effects were too much just take it off. Or wear it only part of the day taking off at night. Now people get blistering rashes at the site my pdocs patient did and had to discontinue it she said. I have two sample boxes of EMSAM in my med box. But I have to be ad free first. And even thought they don't work for me like Jost something keeps pulling me back to them. Even though anxiety is and has been my worst symptem. The anxiety leads to depression when you can't do the things you did before without being afraid . And you think that popping some pill will make it all go away. Love Phillipa
Posted by Edwin Ransom on October 6, 2006, at 22:13:19
In reply to Re: EMSAM/selegiline research articles/statistics., posted by Phillipa on October 6, 2006, at 21:35:48
I have been taking EMSAM for depression at 6 mg/day for 2 months without experiencing significant side effects. I was only anxious and insomniac for the first few days. I have found EMSAM to have substantial mood brightening, and mild anxiolytic effects. I hope you find something that helps you feel better.
Posted by Phillipa on October 6, 2006, at 22:20:08
In reply to Re: EMSAM/selegiline research articles/statistics., posted by Edwin Ransom on October 6, 2006, at 22:13:19
Really? You mean it might help me? Would you please babblemail me and give me your e-mail. I promise not to abuse it or give it away. Or if you're more comfortable keep posting on this thread or babblemail me. Love Phillipa you give me hope.
Posted by jealibeanz on October 7, 2006, at 8:40:07
In reply to Re: EMSAM/selegiline research articles/statistics., posted by Questionmark on October 6, 2006, at 20:43:50
I know I shouldn't give up on treatment and pretend I'm OK because I've had less than perfect responses and undesirable side effects in the past, but it's tough. The only reason I'd consider EMSAM is because it's completely different than any medication than I've taken. I won't an SSRI again, for sure. Maybe something else.
Maybe in a few years some new drugs will actually be approved and on the market, but it's such a slow process. I don't have much hope for anything new in the near future.
There's always talk about new and innovative medications and research being done, especially in relation to genetics, but realistically, we have not benefitted from major advancements in depression meds since the beginning of the "Prozac era".
Posted by psychobot5000 on October 7, 2006, at 16:26:20
In reply to Re: EMSAM/selegiline research articles/statistics., posted by jealibeanz on October 7, 2006, at 8:40:07
I personally identify weight-gain on antidepressants primarily with antihistamine effects, though doubtless there are other mechanisms.
I'd definitely recommend you try EMSAM. I think the studies show it's the best of the MAO inhibitors that don't require eating restrictions, and I think it's fair to say it has fewer side-effects. Never noticed any weight-gain or antihistaminic effects on it, myself.
Since it has a different mechanism of action than most antidepressants, AND works on a different neurotransmitter (dopamine), it's a good one to try. If it doesn't work, or you don't like it for other reasons, then that's too bad...but I can't see why you wouldn't want to try.
Even though I don't take it now, taking selegiline/EMSAM gave me hope, because it was so notably lacking in side-effects that the SSRIs and others all had. EMSAM is quite nontoxic--the main disadvantage, as far as I'm concerned, is that you need to be careful about drug-interactions, and you have to be wary of blood-pressure, especially at higher doses. ...But I never had a lick of trouble with either of those issues myself.
Hope things work out for you somehow,
Psychbot
Posted by jealibeanz on October 7, 2006, at 16:35:26
In reply to Re: EMSAM/selegiline research articles/statistics., posted by psychobot5000 on October 7, 2006, at 16:26:20
Well, I only see a GP, so who knows how he'd feel about this. I'd never reject a possible med because of food restrictions or drug interactions, so that's not an issue for me.
Posted by psychobot5000 on October 8, 2006, at 10:34:37
In reply to Re: EMSAM/selegiline research articles/statistics., posted by jealibeanz on October 7, 2006, at 16:35:26
Ooh. Yeah, I think mot GPs would either be afraid of MAOIs or unfamiliar with them. Still, you could point out that the 6mg EMSAM has been specifically cleared by the FDA as not needing dietary restrictions--there's no labeling to that effect. With a little work, perhaps bringing in some information, you might have a better chance of making him/her go for it. Good luck.
Posted by jealibeanz on October 8, 2006, at 14:57:56
In reply to Re: EMSAM and GPs, posted by psychobot5000 on October 8, 2006, at 10:34:37
Yeah that's my general feeling. Although, he's a bit different than most GP's. This is not a good thing, but he's not the most cautious or detail oriented person. I know he makes a lot of small careless mistakes. Hahaha, I know, I said this is not a good thing. But my point is he's not the kind of practitioner who's so paranoid about doing anything wrong or malpractice suits that he's not willing to stray from the norm occasionally.
Still, the reason why I see him is because he cares about me. I trust him, he trusts me. All other doctors and one horrible pdoc I've seen have completely dismissed the fact that I think I even have anxiety or depression!
My doctor is willing to prescribe me only Xanax for anxiety because we've tried other meds and I did not tolerate them. He's also recently prescribed me Provigil. These are both fairly unorthodox for a GP. He almost gave me a script for a diet pill when I was unhappy about by SSRI weight gain. Haha, at this point I'm not even sure I was actually considered overweight, just up 20 lbs from my usual. I know he's not writing these scripts for the rest of the patients, but he's willing to do so for me.
So, who knows what would happen with EMSAM. At the very least he'd be impressed that I know what it is, understand the mechanisms in full detail. I'm aware of the risks and consequences.
I'd obviously have to be very vigilant in monitoring my reactions and aware of drug and food interactions. But that's not a problem. I'm in PA school. I'm taking pharmacology. It's now my job to understand these things. My friends and I practice blood pressures on each other all the time, so that's easy for me to monitor (I haven't mastered the very tricky skill of taking my own BP).
Posted by Phillipa on October 8, 2006, at 17:44:34
In reply to Re: EMSAM and GPs, posted by jealibeanz on October 8, 2006, at 14:57:56
Oh you will I've done it with practice. Not easy but not impossible. The hardest part is putting the cuff on. Love Phillipa ps the ones that take temp, and BP automatically you can easily do. But their readings are not always acurrate. I don't trust them at all. As I had mine done both ways at the same time or immediately one after the other. Completely differeant readings.
This is the end of the thread.
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