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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by Roslynn on April 26, 2011, at 13:27:49
In reply to asking questions re: emsam theraputic value, posted by floatingbridge on April 25, 2011, at 23:03:46
Hi FB,
Hope you are well.
When I took Emsam at the 6mg dose I had very few side effects. I think I had headaches upon starting it, but nothing on withdrawal.
I had to stop due to the rash, but my current pdoc said the company reformulated the adhesive (?)
Thinking back I probably needed the 9mg dose but then you have to follow the MAOI diet.
Can;t anything be simple????
Roslynn> Is there potential harm commonly associated with the low dose of emsam? Rash, yes. Withdrawal?
>
> Could it be neuroprotective at low dose?
>
> I have nothing to wash out.
>
> Is it an easy on, easy off trial? Like say, Wellbutrin.
>
> I respond brilliantly right now to Ultram ER. Split a 200mg, and 100mg carried me though Easter frivolities in an comfortable way. Not compulsive cleaning. Just able to sit and chat and walk slowly to the beach. My fear is that tolerance would rebuild, I wouldn't feel my limits and overdo or reinjure. However, I was able to enjoy myself and didn't need any norco until about 4:00. 2.5 norco kept pain manageable until bed.
>
> Just thinking. My fatigue is such I don't see me functioning well as a parent. And
> summer is coming. Besides, I still am depressed, though much better--for someone stuck in bed alot.
>
> I realize I've been on the fence forever. When I medicate, I never know what weird sx will appear :-/
>
> Thanks for any comments.
>
>
>
>
Posted by floatingbridge on April 26, 2011, at 15:08:30
In reply to Re: asking questions re: emsam theraputic value » floatingbridge, posted by Roslynn on April 26, 2011, at 13:27:49
Thanks, Roslynn. Was your withdrawal mild enough? That you're thinking of revisiting it says something positive. Is there an equivalent dosage in the segeline pills? (But then, the diet.)
I'm o.k. Not at all great. Nice to hear from you, though. I hope you are well enough or getting there.
Posted by Roslynn on April 26, 2011, at 15:53:20
In reply to Re: asking questions re: emsam theraputic value » Roslynn, posted by floatingbridge on April 26, 2011, at 15:08:30
FB,
I think that yes, the withdrawal was mild. I wouldn't mind trying the patch again except that I am unable to withdraw from prozac.
I don't know how the doses compare with selegiline, but you are correct, you have to follow the diet if on selegiline.
Roslynn
> Thanks, Roslynn. Was your withdrawal mild enough? That you're thinking of revisiting it says something positive. Is there an equivalent dosage in the segeline pills? (But then, the diet.)
>
> I'm o.k. Not at all great. Nice to hear from you, though. I hope you are well enough or getting there.
Posted by henryo on April 27, 2011, at 4:54:27
In reply to Re: asking questions re: emsam theraputic value, posted by Roslynn on April 26, 2011, at 15:53:20
I use the EMSAM (selegiline transdermal system 6mg/24h) intermittently to reset my sleep wake cycle when it gets completely upsidedown- which can be maddening for me. I cut them in half usually. I do three to five days at a stretch two to three times a year. Its very hard to describe the sensation I get from it. (It makes me feel sort of serious but in a good way, however it is somehow tiring. It gives me a slight hint of a headache sort of, or maybe an enforced sense of concentration. I don't love the feeling.) I told you it is a strange thing. Man, we are such guinea pigs here. Anyway it helps me feel tired at night and not sleepy in the day and it certainly lifts my mood or removes depression. It does not cause any sort of euphoria like Ritalin does, I wish it did a little. I have never noticed any rashes or real withdrawal symptoms. I have never done it for anything like a solid month though. But those patches STICK. If you don't like pulling off bandaids look out. I am very grateful that they make it and it is a great med to have in my tool kit. So to speak. Looking at the time right now I really ought to use it tomorrow and for the next week. The start of summertime can put the zap on my my head.
Posted by SLS on April 27, 2011, at 5:43:08
In reply to Re: asking questions re: emsam theraputic value, posted by henryo on April 27, 2011, at 4:54:27
> I use the EMSAM (selegiline transdermal system 6mg/24h) intermittently to reset my sleep wake cycle when it gets completely upsidedown-
That's fascinating. A friend of mine has a non-24 hour circadian rhythm disorder (Non-24-hour sleep-wake syndrome). I think I'll pass along your observations.
- Scott
Posted by SLS on April 27, 2011, at 5:45:19
In reply to asking questions re: emsam theraputic value, posted by floatingbridge on April 25, 2011, at 23:03:46
As best as I can surmise, with a few exceptions, Emsam is not a very potent antidepressant. However, it does seem to help with social anxiety beginning early in treatment.
- Scott
Posted by floatingbridge on April 27, 2011, at 9:33:01
In reply to asking questions re: emsam theraputic value, posted by floatingbridge on April 25, 2011, at 23:03:46
Thanks for responses. Pdoc didn't think it Would help, and I'm not talking anyone into anything these days.
This is a low point for me. The idea of going to the major university hospital for their pain and fatigue specialists met with more approval.
I should be happy I have a pdoc who won't medicate me.
Posted by floatingbridge on April 27, 2011, at 9:41:07
In reply to Re: asking questions re: emsam theraputic value, posted by henryo on April 27, 2011, at 4:54:27
Henryo, did you figure this out yourself? Very interesting. Can you say more about how your sleep cycle being upside down? Is it what Scott called it?
(I have since memory been one to push my cycle forward, going to bed later and later. As a child, too. Is this similar? For me, it this maddening. That, and feeling more energetic past 11:00 pm if not in
bed or with a sleep aid.)
Posted by Phillipa on April 27, 2011, at 20:16:42
In reply to Re: asking questions re: emsam theraputic value » henryo, posted by floatingbridge on April 27, 2011, at 9:41:07
Same with me and I've not heard of EMSAM being used this way. Henyro could you comment more on this? Pain clinic no ad? I'm guessing that is good. Phillipa
Posted by wilyee on April 27, 2011, at 21:15:32
In reply to asking questions re: emsam theraputic value, posted by floatingbridge on April 25, 2011, at 23:03:46
Wanna thank you on your well wishes when i was in jail.Regarding emsam,i dont know of the actual patch,but i used the liuid drops often and reseached it to death.
Yess at low doses deprenyl is said to be nueroprotective on dopamine.
Liquid deprenyl was the closes thing to parnate i came across,i felt the dopamine effects from both.
I waited for that patch thinking it was my thing.To get off parnate,but after visting so many sites and reviews on it i deceded it wasnt a replecment/
Posted by floatingbridge on April 28, 2011, at 1:49:08
In reply to Re: asking questions re: emsam theraputic value, posted by wilyee on April 27, 2011, at 21:15:32
Wilyee, hey, how are you? Are you working on a documentary piece?
Deprenyl is liquid segeline? And I know you have probably wrote about this, but why off parnate? That is the one maoi I had really wanted to try. I have a friend doing so well on it.
I felt a low supplement of emsam would
help after two years of dexedrine, esp. in light of a recent study suggesting a link between early onset parkinson's and stimulant therapy. (And because I feel
so cr*ppy.) I think with all my current health issues, he is probably being conservatively correct. He doesn't really prescribe maoi's.
If I continue at this rate or worsen, I feel it might be time for a second opinion.Thanks for the info wilyee. I like how I can recognize the letters of your screen name in whatever order and know it's you :D
fb
Posted by SLS on April 28, 2011, at 4:51:52
In reply to Re: asking questions re: emsam theraputic value » wilyee, posted by floatingbridge on April 28, 2011, at 1:49:08
Hi FB.
> I have a friend doing so well on it.
What diagnosis?
In what ways is your friend improved?
Thanks.
Keep up the good work.
- Scott
Posted by wilyee on April 28, 2011, at 8:24:18
In reply to Re: asking questions re: emsam theraputic value » wilyee, posted by floatingbridge on April 28, 2011, at 1:49:08
Noooo im not off parnate,but the high dose and lil pills everywhere made me wait for emsam as a alternative,but after reading i stayed with parnate,which is working for me at doses of 100 mg.
Ha documentry,im lucky i got out of there,but yeah its me,u know by the bad spelling and grammer,also feel free to google brklyn234 and see the history i have off this board in other groups working with all types of meds,supplements etc.
Posted by Willful on April 28, 2011, at 9:36:17
In reply to Re: asking questions re: emsam theraputic value, posted by wilyee on April 28, 2011, at 8:24:18
Posted by floatingbridge on April 28, 2011, at 13:02:32
In reply to Re: asking questions re: emsam theraputic value » floatingbridge, posted by SLS on April 28, 2011, at 4:51:52
Hey Scott,
She's an odd one amongst oddities. She has never admitted to any diagnosis per se. She has talked about certain times in her life (suicidiality, being 'really down'), but runs at mention of psych talk.
My observations are a pronounced slowing down of all functioning plus an
incredible reluctance to socially engage. On parnate she participates more and self care is improved. She is funny and very creative, but profoundly shy and sensitive. The parnate gets her out of bed and allows her to talk. She has said it is the only one, even amongst maoi's, to work for her.This helpful?
(Thanks for your ongoing support.)
fb
> Hi FB.
>
> > I have a friend doing so well on it.
>
>
> What diagnosis?
>
> In what ways is your friend improved?
>
> Thanks.
>
> Keep up the good work.
>
>
> - Scott
Posted by floatingbridge on April 28, 2011, at 13:05:09
In reply to Re: Emsam has lots of therapeutic value imo (nm), posted by Willful on April 28, 2011, at 9:36:17
I would think so, too. Thanks Willful.
I might eventually get a second opinion.
Do you have actual experience with it?
Posted by henryo on April 29, 2011, at 2:06:48
In reply to Re: asking questions re: emsam theraputic value » henryo, posted by floatingbridge on April 27, 2011, at 9:41:07
I did sort of stumble onto using it this way myself. I think my biological-psychiatrist called my condition "delayed sleep phase syndrome". I tried Trazodone but it leaves me groggy. Light therapy certainly works but I have a real aversion to bright lights in my eyes. So when my sleep cycle gets flipped, I try to stay up all 24 hours till the next evening. Then I use the Emsam patch and a lot of self-discipline to get it righted. There is no such thing as depression without sleep disorder or sleep disorder without depression. They don't even know if they are separate issues. March is often a bad month for me. I have a history of depressions around this time of year often near hibernation. I can get so sleepy in the daytime that it hurts. Anyway I use what I have learned. In the last several years I am way way better than ever. But I sometimes have rough periods. If I can notice them before they really take hold and do something to change it, then I'm better off.
After I said the other night that I ought to be using Emsam now, I did. But I decided that I have a history of using the very least amount of any med that I possibly can. That has been something instilled in me. Don't take more than you need. That has lead to not taking enough meds when I actually need them. Anyway I decided to use the whole patch because that is how they were designed. I should have stuck with the system I devised before. I put a whole patch on yesterday, 4 hours later I started really feeling it. I don't like it when I can feel a med that powerfuly. So I took it off and started again today with a half. I think this is good. I'll be going to sleep soon instead of in 3 to 4 hours. I feel tired just before midnight which is rare for me. Goodnight.
Posted by floatingbridge on April 29, 2011, at 11:36:53
In reply to Re: asking questions re: emsam theraputic value, posted by henryo on April 29, 2011, at 2:06:48
Thanks Henryo. That you worked this out on your own is excellent imo.
I like your observations about depression and sleep, too. The importance of sleep is really hitting home right now for me. Sleep issues underlie or at the very least coexist with so many conditions and disorders.
Thanks for writing this out. I find it helpful.
Hope your night was good.
P.S. tinkering with meds is kinda' irresistible, lol. Glad yours was a one day only experiment.
Posted by mtdewcmu on April 29, 2011, at 18:20:18
In reply to Re: asking questions re: emsam theraputic value, posted by henryo on April 29, 2011, at 2:06:48
> There is no such thing as depression without sleep disorder or sleep disorder without depression. They don't even know if they are separate issues.
I think you may be right that there is no depression without sleep disorder. I'm not sure if it works the other way, though. Do you think that narcolepsy is a subtype of depression? Or do you merely think that sleep disorders ultimately cause depression?
Posted by annabamma on April 29, 2011, at 18:40:15
In reply to asking questions re: emsam theraputic value, posted by floatingbridge on April 25, 2011, at 23:03:46
I tried the patch, had to stop because of rash. Then I was on 15mgs. of segeline pills for almost a year. It REALLY helped my winter-sleep and eat (aka hibernation) problem- and I had no problem with the MAO diet, because along with taking Metformin, I lost most my appetite. I lost 50 lbs. If only I could have had a little serotonin for my slight irritability, it would have been almost perfect. I switched because of my pre-existing problems with hot flashes and anxiety attacks. I am just coming out of this winter tired and sluggish, after being on Effexor since fall. Maybe I'll try segeline again.
Posted by henryo on April 30, 2011, at 2:59:37
In reply to Re: asking questions re: emsam theraputic value » henryo, posted by mtdewcmu on April 29, 2011, at 18:20:18
I didn't come up that thing about sleep on my own. My biological psychiatrist says it often. Your right, narcolepsy is probably an exception to that, then again narcolepsy looks like it could be pretty depressing. It applies to the early waking, insomnia and or hypersomnolence. I am a champion sleeper.
Posted by Willful on May 1, 2011, at 9:47:18
In reply to Re: Emsam has lots of therapeutic value imo » Willful, posted by floatingbridge on April 28, 2011, at 13:05:09
Hi, fb,
I've used emsam for quite a while, and it 's the only thing that helped me significantly. I use some adjunctives like provigil (which I was on before the emsam) and occasional ritalin because I don't sleep well (I also had insomnia before emsam) I'm starting to sleep better, so I don't think it's impossible to sleep with emsam, despite its activating properties.
I also had a trial of parnate, which was a mixed success at best and cymbalta, which helped a small bit, but also caused some bad side effects for me (I'm very sensitive to serotogenics). I don't recommend cymbalta,particularly, based on my case and what I've read-- but I think it's always worth trying if you haven't--
But I really believe emsam is a ~ very very ~ good med. Maois in general are pretty effective compared to other available meds, and emsam is absolutely a lighter and stronger drug for me than parnate. I had pretty severe depression for most of my life and was unable to use ssris and other drugs like wellbutrin, remeron, and several others, which I tried briefly.
I've been lucky with the rash; however, I do get red marks after I use the patch in areas for a while (I switch placement around a bit) -- however, if you put cortisone (otc) on right before, and after, and move it around a lot, I think it's not necessarily a problem- also some months are worse than others. I assume the manuf. doesn't put the adhesive on quite right. You may not need anything---however-- I don't use anything except on rare occasions. I had some other ideas for reducing the itchiness, but it never became that much of a problem although some days it is itchy.
I would absolutely encourage you to try it. Also to be honest, if you can get rilutek, which is very expensive and may not be covered on your insurance, I would truly recommend that. It may not be around very long, though-- so maybe it won't be a long term med. I truly will be very upset if they take it off the market (or my insurance co won't pay for it any more). Contrary to many reports here, I've found it very effective for anxiety and depression along WITH the emsam. (I don't know anything about using it on its own.)
I hope you can convince your pdoc to give you emsam. I can't see any argument at all against it.
I did have a case of a chronic fatigue-like syndrome at one point a long while back-- and I know how hard that can be. I only hope you can find something to help you with that and the fibromyalgia. I'm so sorry that you've gone through so much on top of the depression.
Posted by floatingbridge on May 1, 2011, at 10:44:15
In reply to Re: Emsam has lots of therapeutic value imo » floatingbridge, posted by Willful on May 1, 2011, at 9:47:18
Willful, thanks for all information. I'm becoming med sensitive, too :( Cymbalta worker really well for pain, I mean super, but there was alot of cognitive dulling, oddly exacerbated depression, but the real kicker was gastritis.
Rilutik. I've seen it discussed here.
Thank you! You are feeling well enough
yourself? Since you had a chronic fatigue on top of depression, I imagine you know it's very crazy making.fb
Posted by floatingbridge on May 1, 2011, at 10:45:55
In reply to Re: asking questions re: emsam theraputic value, posted by annabamma on April 29, 2011, at 18:40:15
Posted by floatingbridge on May 2, 2011, at 12:59:59
In reply to Re: Emsam has lots of therapeutic value imo » Willful, posted by floatingbridge on May 1, 2011, at 10:44:15
This is the end of the thread.
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