![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 407 to 431 of 431. Go back in thread:
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
Posted by War-Face on October 22, 2007, at 21:07:34
In reply to Re: selegiline dose/delivery and longevity?? » War-Face, posted by Phillipa on October 22, 2007, at 20:42:36
Posted by Phillipa on October 22, 2007, at 21:30:56
In reply to That's what I'm asking :) (nm) » Phillipa, posted by War-Face on October 22, 2007, at 21:07:34
Well then I hope you're right. Phillipa ps wanted to try EMSAM for the longest time. Two boxes waiting to be used.
Posted by KarenRB53 on May 7, 2008, at 14:58:56
In reply to Re: EMSAM » jetcity10, posted by RobertDavid on April 27, 2006, at 0:14:56
> > I have now been on EMSAM for one week. Though I have not seen a miraculous improvement I have to say that there is clearly some improvement. I too have been on and off numerous anti-depressants through the years with little positive effect and lots of negative effects. This is the first where I can see some raising of the lowest feelings. I have also had glimpses of hope which I have not had in years and glimpses of a positive life - both of which are new since EMSAM. I still feel depressed, but like I said, the low seems a little better. The anxiety is pretty high. However both the depression and anxiety are probably influenced by significant life events that had increased the severity of both before starting the EMSAM.
> >
> > As to side effects: maybe some increased anxiety, maybe less sleep (even on the 1.5mg Klonipin), a little orthostatic hypotension, and it looks like some minor constipation.
> >
> > But I have more energy (even with less sleep) and have even been looking forward to working out (an amazing thought).
> >
> > Overall, this has been one of the best responses I have ever had since there is positive response and no side effects I can't deal with yet.
> >
> > Rob, thanks for your posts, it gives hope that it can get even better, but even if it doesn't, some is better than none.
>
>
> That sounds like a very positive start and similar in many ways to mine. I too noticed that I slept a little less at first, but woke up energized, felt like doing more. I too started working out at the gym again as before I just didn't couldn't get myself to do go there.
>
> I hope that your benefits will continue and side effects will be minimal. Like you I never really knew what it felt like to have a postive start any med other than klonopin.
>
> Please keep posting your results and I wish you the best! Rob
Are you still using EMSAM and is it still working as well for you?Thanks, Karen
Posted by KarenRB53 on May 7, 2008, at 15:07:42
In reply to Re: EMSAM-Time for next refil, posted by Paul on Long Island on April 30, 2006, at 19:09:06
> Hi guys...Paul again. First off, I want to congratulate you Rob for the wonderful response you've gotten on the medication. I hope and pray that so many, many people will find the same kind of relief you've found. Unfortunately, I've come to the conclusion, for several reasons, that I'm not going to be one of those lucky ones with Emsam. I've been on the patch for 13 days now. While I know most people shouldn't expect to have a great, or perhaps even minor improvement in that time, I've had a worsening, horrible depression and SEVERE anxiety and OCD in that time. My original reasons for going on emsam were due to a large weight gain and sexual side effects from prozac. Foolishly and selfishly, I didn't appreciate the fact that those things are extremely minor in the grand scheme of things, considering I had always had GREAT help from the prozac. Several people questioned why I would stop taking something so effective for only a possibility of relief from something completely different. While it may have made some kind of weird sense to me at the time, those of you who questioned it were absolutely right. Except for those side effects, I was living a very good, relatively stable emotional life. I have an appointment with my psychiatrist tomorrow, and I plan to tell her I'm quitting the emsam. She had given me lithium to try to boost the effect of the emsam, along with klonopin and xanax to get through the severe anxiety. So, I'm hoping to muddle through the next 14 days until I can go back on prozac. I hope I don't lose what's left of my mind :) One concern I have now is EGAS's posting. Apparently you've had trouble with getting off of the emsam. You mentioned severe anxiety and panic. I pray that those things will go away for you quickly. I hope that between the lithium, klonopin and xanax, I can avoid feeling any worse than I have for the past 2 weeks. It seems like the effects you've gotten from withdrawal from the emsam are the same effects I've gotten while ON it! I guess time will tell. I'll let you all know how I make out. And please, EGAS, keep us posted on how you make out. I'm pulling for you, and I'm sure everyone else is also. One more time, I want to thank you all for the incredible support, information and advice you've all given. Whatever else can be said about people with our conditions, you're obviously all extremely giving and caring people. God Bless you all! Paul
Just wondered if you did go back to Prozac? I've got the same problem with Prozac. I've been on it approx 10yrs and I've gained 30 lbs but also I now have high blood pressure, high cholesterol, hypothyroidism and type2 diabetes. I'm not saying its all the Prozac but partly could be. Also, the last few months Prozac does not seem to be working as well so I've been considering the EMSAM patch.
Thanks for any info.
Karen
Posted by KarenRB53 on May 7, 2008, at 15:12:39
In reply to Re: EMSAM-Time for next refil » theo, posted by RobertDavid on May 2, 2006, at 18:24:55
> > I'm starting the patch as soon as I get my nerve up, I have had the scrip for a week!
> >
> > Do you find any difference in absorbtion in placing it on your upper body versus your thigh or hip (underwear area)?
>
>
> I've pretty much kept the patch on my upper back, chest and arms. I like to keep it high as I like to take long hot baths at night and they say you're suppost to avoid long periods of heat exposure so by keeping it high it doesn't soak in the hot water (for long periods).
>
> On a couple of occations I placed it on my stomach, but never my legs. There are so many options to place it I really don't pay much attention to it and can't say that I've noticed much difference. The chart seems to suggest that it's fine either upper or lower body (outer thighs), but I suspect it doesn't make much difference. I just slap it on where ever I feel like it.
>
> Since I've had such a positive response I will say I like the idea of having on my upper body as I want as much of the drug to get to my brain as possible, but that's just my little mental thing and probably doesn't matter at all. Once I put it on I give it a few good slaps to make sure it sticks well as I want the selegiline to really soak in.
>
> I wish you the best of luck with it and I hope this info helps. RobJust wondered if you're still using the EMSAM and how well its still helping you? I've been considering it.
Karen
Posted by RobertDavid on May 7, 2008, at 16:33:19
In reply to Re: EMSAM-Time for next refil, posted by KarenRB53 on May 7, 2008, at 15:12:39
> Just wondered if you're still using the EMSAM and how well its still helping you? I've been considering it.
>
> Karen
Karen, I'm not currently taking it. It helped me through the issues I was dealing with during that period. I have gone back to it a few times when I needed to and always seem to get a quick positive response. I found I only needed a small dose to help me, sometimes even cutting the patch in thirds.But my primary disorter is anxiety and have continued to take Klonopin for that. EMSAM was something that in small doses helped with energy, mood and mental clarity, but I suspect not with anxiety. When I'm doing good, taking good care of myself, working out, eating right and keep my stress low I've found I can make it without EMSAM. I'm not clinically depressed so my circumstances, dosing and usage probably doesnt apply to most.
I still keep it and will go back to it if and when needed. Provigil at a super low dose (25mgs) has also helped me with the above mentioned issues on occation.
I hope that is of some help to you....
Rob
Posted by Phillipa on May 7, 2008, at 19:29:34
In reply to Re: EMSAM-Time for next refil, posted by RobertDavid on May 7, 2008, at 16:33:19
Hi my friend. Miss you. Love Jan
Posted by daflyingmir on August 18, 2008, at 4:31:13
In reply to Emsam Price, posted by cecilia on April 11, 2006, at 18:10:24
I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
Posted by KarenRB53 on August 18, 2008, at 8:29:19
In reply to emsamer for 1 year, posted by daflyingmir on August 18, 2008, at 4:31:13
> I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
Thanks so much for sharing this info. Do you have major depression and anxiety? Also, are you taking just the Ensam and thats all right now? Sorry for the questions, I'm having a difficult time and want to try the patch however my pdoc is concerned because I'm taking meds for high blood pressure and he's concerned that the Ensam will cause my blood pressure to increase. Thats why I appreciated the note about the Adderal. Do you normally have problems with high blood pressure (take meds)?
Thanks again,Karen
Posted by daflyingmir on August 18, 2008, at 8:38:35
In reply to Re: emsamer for 1 year, posted by KarenRB53 on August 18, 2008, at 8:29:19
> > I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
>
>
>
> Thanks so much for sharing this info. Do you have major depression and anxiety? Also, are you taking just the Ensam and thats all right now? Sorry for the questions, I'm having a difficult time and want to try the patch however my pdoc is concerned because I'm taking meds for high blood pressure and he's concerned that the Ensam will cause my blood pressure to increase. Thats why I appreciated the note about the Adderal. Do you normally have problems with high blood pressure (take meds)?
> Thanks again,
>
> KarenI was on 2 other anti depressants before (paxil and lexapro) and had serious issues with both. That's when my doctor decided to put me on emsam. My blood pressure actually usually runs on the low side. My blood pressure is still the same it was before the patch, the even with the adderall was an isloated incident. Emsam usually doesn't affect your blood pressure unless it interacts with something and then you run risk of it spiking very high very fast. There's a long extensive list of drug interactions including all decongestants (that kinda sucks when you are like me and have allergies up the wazoo) But I rather be snotty than get stuck in the psych ward.
Posted by tnmom on August 18, 2008, at 8:49:18
In reply to emsamer for 1 year, posted by daflyingmir on August 18, 2008, at 4:31:13
> I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
Hi! I'm new to this site and have just read your post. I have also been on Emsam (6mg/24hr) over a year (4/07) and it worked really well, now the effects don't seem to be working as well. I was using the patch everyday, then the pdoc said that I could use one patch for 2 days. Maybe that could be the problem, I should probably use a new one everyday. He wants to up my dosage to the 9mg, but I'm terrified to do that! He gave me the script and one for hypertension crisis, me, someone who is afraid to take anything new! Needless to say, I'm not using the 9mg! I'm also taking Xanax XR 0.5 mg - 2 times a day, Depakote 500 mg - 4 times a day and Seroquel @ bedtime. I have been cutting down on the Seroquel for awhile now (due to weight gain in combo with the Depakote), it's 25 mg and I'm now on a quarter of that at night. Having trouble getting to sleep even after taking the Seroquel. After taking the Seroquel it takes about 2 hours to get to sleep, sometimes I go on to bed even if I'm not sleepy. Read about insomnia on alot of posts with Emsam! Sometimes, I also have dreams/nightmares that wakes me (and hubby) up crying uncontrollably. Normal? Could use some advice, please. Thanks!Sorry, forgot to add what I've been diagnosed as having. Bi-polar II, depression, anxiety and ocd.
Posted by daflyingmir on August 18, 2008, at 9:37:06
In reply to Re: emsamer for 1 year, posted by tnmom on August 18, 2008, at 8:49:18
> > I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
>
>
> Hi! I'm new to this site and have just read your post. I have also been on Emsam (6mg/24hr) over a year (4/07) and it worked really well, now the effects don't seem to be working as well. I was using the patch everyday, then the pdoc said that I could use one patch for 2 days. Maybe that could be the problem, I should probably use a new one everyday. He wants to up my dosage to the 9mg, but I'm terrified to do that! He gave me the script and one for hypertension crisis, me, someone who is afraid to take anything new! Needless to say, I'm not using the 9mg! I'm also taking Xanax XR 0.5 mg - 2 times a day, Depakote 500 mg - 4 times a day and Seroquel @ bedtime. I have been cutting down on the Seroquel for awhile now (due to weight gain in combo with the Depakote), it's 25 mg and I'm now on a quarter of that at night. Having trouble getting to sleep even after taking the Seroquel. After taking the Seroquel it takes about 2 hours to get to sleep, sometimes I go on to bed even if I'm not sleepy. Read about insomnia on alot of posts with Emsam! Sometimes, I also have dreams/nightmares that wakes me (and hubby) up crying uncontrollably. Normal? Could use some advice, please. Thanks!
>
> Sorry, forgot to add what I've been diagnosed as having. Bi-polar II, depression, anxiety and ocd.
>Yeah I wouldn't do the every 2 day thing, it tends to screw things up when your body doesn't have the chemicals for even a day. If you do get upped to 9mg you have to start following that stupid diet which is almost impossible to follow because there are so many things you cant eat. I can't take take xanax or anything in that family. The day I went to the ER with the hypertensive crisis the ER docs wrongly diagnosed me and said I was having a panic attack ( i could barely lift my head because it hurt so bad and i kept on passing out, you cant tell me that's a panic attack)and gave me Valium. Come to find out when I lost feeling in my legs, started hallucinating, and got massive sores in my mouth that I was allergic to it. I didnt find that out or that what was going on was actually a hypertensive crisis until the next day when I had a follow up appt. at the mental health clinic. I have insomnia as well, but I had problems even before the emsam. I've always been nocturnal. I'm on ambien right now which isn't cutting it at all. I keep on waking up 5 times a night for no reason on that stuff. Have you tried trazadone? lol that stuff knocks you right the heck out but you kinda feel a tad groggy the next day though. I had night terrors a while ago and they had me on visteral(sp?)and that helped but the next day I felt like a zombie because the effects didnt fully wear off the next morning.
Posted by KarenRB53 on August 18, 2008, at 9:46:47
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
> 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........
>
>Hi:
Wondering if you're still back on Ensam and did it work as well for you the 2nd time as it did the 1st time?Karen
Posted by TexasRVer on August 18, 2008, at 22:32:46
In reply to Re: First Day - Again, posted by KarenRB53 on August 18, 2008, at 9:46:47
I have read most of the posts in this tread and find it interesting how varied the reactions to Emsam have been.
I started on 6 mg. Felt better, but not much, so increased to 12 mg. Prior to Emsam, I was so tired all the time and just did not want to do anything. Pdoc said that I would have so much energy that I would want to do stuff and be on the go all ahte time. That did not happen, but id did feel better. However, she also said that it would help the weight gain, and it did not, I just continued to gain.
I guess different docs have different ideas about dosage. She told me to "play" with dosages until I settled on what was right for me--to cut the patches for different dosages. Then, due to the cost, she said that I could leave one on longer than 24 hours, or change every 48 hours. Just try different things. Before my problem with cough syrup and having to go off the Emsam for a while, I was using 9 mg/day and leaving one patch on longer. I figured by doing that, I was getting the 12 mg/day but cutting the cost a bit. It seemed to work just fine.
Since the package insert says to not expose the area to sun, I asked about that since the weather is beautiful and I wanted to lay by the pool. She said that I did not have to wear the patches in the locations indicated, but could place it where it would be under my swimsuit and not exposed to the sun.
I guess all pdocs and all patients are different!!!
I am anxious to get back on it. The past few days since I got over the reaction to the cough syrup, I feel really good, but don't want to wait until I get too far down again before I get back on it. Just hope the time off does not change my response to the patch.
Jurhee
Posted by KarenRB53 on August 19, 2008, at 8:16:03
In reply to Re: First Day - Again, posted by TexasRVer on August 18, 2008, at 22:32:46
> I have read most of the posts in this tread and find it interesting how varied the reactions to Emsam have been.
>
> I started on 6 mg. Felt better, but not much, so increased to 12 mg. Prior to Emsam, I was so tired all the time and just did not want to do anything. Pdoc said that I would have so much energy that I would want to do stuff and be on the go all ahte time. That did not happen, but id did feel better. However, she also said that it would help the weight gain, and it did not, I just continued to gain.
>
> I guess different docs have different ideas about dosage. She told me to "play" with dosages until I settled on what was right for me--to cut the patches for different dosages. Then, due to the cost, she said that I could leave one on longer than 24 hours, or change every 48 hours. Just try different things. Before my problem with cough syrup and having to go off the Emsam for a while, I was using 9 mg/day and leaving one patch on longer. I figured by doing that, I was getting the 12 mg/day but cutting the cost a bit. It seemed to work just fine.
>
> Since the package insert says to not expose the area to sun, I asked about that since the weather is beautiful and I wanted to lay by the pool. She said that I did not have to wear the patches in the locations indicated, but could place it where it would be under my swimsuit and not exposed to the sun.
>
> I guess all pdocs and all patients are different!!!
>
> I am anxious to get back on it. The past few days since I got over the reaction to the cough syrup, I feel really good, but don't want to wait until I get too far down again before I get back on it. Just hope the time off does not change my response to the patch.
>
> Jurhee
Hi:
What happened when you took cough medicine? Do you have to stay off the Emsam patch for long because of the cough medicine. Do you mind my asking, were you on other antidepressants before you tried the patch? Also, did it help with anxiety?Karen
Posted by TexasRVer on August 20, 2008, at 21:58:19
In reply to Re: First Day - Again, posted by KarenRB53 on August 19, 2008, at 8:16:03
> Hi:
> What happened when you took cough medicine? Do you have to stay off the Emsam patch for long because of the cough medicine. Do you mind my asking, were you on other antidepressants before you tried the patch? Also, did it help with anxiety?
>Karen
For what happened with the cough medicine, see the thread that I started "MOAI reaction". It describes it---not fun. Because everything says not to use MOAI for 2 weeks after meds that can cause a reaction, I am waiting a few more days. It has been about 1 1/2 weeks.Through the years, I have tried so many different things that I cannot even remember them all. The one that helped most was Effexor. I was on 375 mg/day and Ritalin (ADD). It helped, and after a couple of years, I gradually tapered off, and took nothing for quite a while. After the death of my, and 2 fur critters within 6 months and a dx of breast cancer, I was a 'basket case' and had to have something. I tried Effexor, and it made me VERY sick. I kept trying, because it had worked. Even 1/2 of a 37.5 tablet made me sick. So, of course, I gave up. I think the cancer did something because before, I was taking Xanex 1-2 mg/day. Now, if I cannot sleep I take 1/2 of a quarter mg tablet!!! In fact, a few days ago I broke the half tablet in half. That is all I needed. Don't know why I got so sensitive to stuff. Anyway---I am rambling---
My depression is certainly not as severe as it sounds like most of the members of this board. I knew even as a teen-ager, or before that something was wrong, but I did not know what. I don't think that they had a name for it way back then. I was in my 50's before the dx of ADD and dyslexia. Life sure would have been easier if we had known about them way back when!!
My sister, my son, and my grand-daughter area all bi-polar and ADD. I count my lucky stars that I am no where near as bad as they are!!!
Posted by utopizen on August 26, 2008, at 21:16:24
In reply to emsamer for 1 year, posted by daflyingmir on August 18, 2008, at 4:31:13
>>On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway.
>>I'm glad to hear you're finding great results with this. I'm sorry to hear you had to go through a hypertensive crisis... but please keep in mind, if your doctors heeded every printed "interaction," a lot of meds wouldn't even be an option for folks.
As someone who had terrific results with it the drug in tablet form, I took 10mg of it (not sure how this compares with patch) with Lexapro, Klonopin and Adderall. Never had hypertensive crisis.
I also didn't mention to my doc the combo. I was desperate to get out of depression, and knew he'd never script the combo, and yes, Dr. Bob would not approve, so don't try this at home. It's quite likely one might risk Serotonin Syndrome, hypertensive crisis, God knows... all i know is, I happen to be quite resilient to meds, and I'm not sure how my heart has put up with me to this point. =)
Doctors take risks when they combine meds all the time. It's likely they weighted the risk of the combo, and felt the risk of potentially having a hypertensive crisis outweighed the benefit you receive from Adderall.
Also, it's likely they thought the interaction risk was somewhat minimal, in light of the patch's unique effect. It's only rather recently that the patch is appearing to induce hypertension at all in the lower doses... but like any drug, certain people are sensitive to it more than others, so these things can and do happen.
your doc isn't a space cadet, and cares about you. He takes risks, yes, and now and then they seem silly in hindsight. Honestly, if a doc told me I'd have to stop a stimulant to go on a drug, it would basically be like saying, "you need to take a year off school." And also, lots of things interact with amphetamines. A lot of things. For the same reason hypertensive crisis. So docs are use to reading that.I think it's easy to blame docs quite a bit, and certainly, I went through my time here on this board doing the same. But ultimately, they took a risk for hypertension altogether by introducing Emsam, Adderall or not. And if they were more conservative, they would not have prescribed Emsam altogether, and you might very well not have benefited from it.
anyhow, glad you're doing well =)
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