![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 94. Go back in thread:
Posted by pulse on June 8, 2006, at 10:06:27
In reply to Re: Emsan-Day 30, posted by cecilia on June 8, 2006, at 9:05:17
i didn't know before reading here that emsam had been tested on this RARE group with depression only. now, i'm suspicious, too, as i've never known, nor even heard, of one single person with only depression.
quite understandibly, with the way you're feeling, you're being pretty hard on yourself re: your personality. you don't state that you've ever been dxed with a personality disorder, however. if, for instance, you did happen to also have borderline pd, i'd strongly suggest therapy, WAY before ANY meds, but only if it was Dialectical Behavioral Therapy.... that's for sure.
i can't relate to sp at all, so can't respond - except to agree that many sp-ers here are seemingly having success with emsam for that. i agree that one can't change their basic nature, but i don't see that sp folks would be considered unlikeable.
yes, emsam has a 1.2 pound per month weight loss. i'm also doing some night-time eating, but mostly just dry cereal - carbs to help a little with the much lesser than before insomnia... that i still have.
another thing as a possibility for your insomnia: did you see the posts talking about releasing - by december - the 1, 3, and 6 mg. doxepin/ sinequan ...just for sleep? i have a compounding pharmacy available and 1 refill left of sinequan, and they've agreed to do (at first) a few 1 mgs. for me. not that any real compounding is necessary, i guess - just extracting an accurate 1 mg. and putting it in a plain capsule. no way i could do that myself - i've sorta tried...no dice. i figure/ hope 1 mg. can't give me constipation and reflux, although with my guts, who knows?
for 25 yrs, all pdocs have really pushed that my mdd was 100% endogenous. my therapist has finally felt it was time that i could accept that, no, quite abit of it is from the fact that i have a severely narcissistic personality disordered father; then, of course, i gravitated to same or similar men in adult life - even when i was SO sure they were the exact 'opposite.'...and not 1 second older than me. so it goes. things are getting better for me re: this bit also. it can be very devastating. out of the 4 clients she has with dad's like mine, i am 1 of 2 who has never made an active suicide attempt.
pulse
Posted by pulse on June 8, 2006, at 10:15:04
In reply to Re: Emsan-Day 30, posted by cecilia on June 8, 2006, at 9:42:09
welp, i'm cutting it AND taking the patch off, after 4 hrs. - tops.
it's working for me so well i can't believe it. granted, it's still fairly early in this 5th attempt of mine, but, before, the longest i could tolerate the patch was 4 days!
pulse
Posted by Last Chance on June 8, 2006, at 12:23:40
In reply to Re: Emsan-Day 30, posted by pulse on June 8, 2006, at 10:15:04
Hi - yes the patch seems very tricky to find out what works - I still haven't. I am on day 12? Started with 1/2 patch 24 hr's. Not so bad, a bit more anxiety, more difficulty sleeping. Then I put on the whole patch 6mg and had a very energetic, and happy? day accomplishing a lot here on the farm - I did not interact socially, just stayed at home. That night could not sleep and was going nuts with anxiety, so I ripped off the patch at 2 or 3 in the morning. 2 hr's sleep that night and a very depressed next day. I have upped my Klonapin to .5mg per day, and yesterday I did 2/3 of a 6mg and took off 2 hrs. before bedtime - I slept pretty normally. Yes I posted once before I didn't see how one could keep a constant level and get to a therapeudic dose by taking off - seem's like the answer to that is still not clear. I am not sure what approach I will take today? maybe the whole thing and take off before bed? SP has been my major problem my whole life as far back as I can remember, and the depression has crept in the last 20+ years and progressively gotten worse. Richard
Posted by RobertDavid on June 8, 2006, at 12:31:21
In reply to Re: Emsan-Day 30, posted by Last Chance on June 8, 2006, at 12:23:40
Richard:
Have you considered going up on klonopin? That is one of the most effective meds for SP. EMSAM may help some for increasing mood/sociablity, but I feel it's primary benefit is for depression. I take 2mgs of klonopin and it knocks out SP. Until I got to a high enough dose it just gave minor anxiety relief. That said, the blend of klonopin and EMSAM has been the answer for me, but without klonopin, I doubt I'd be able to leave the house and work. Just a thought.
Posted by RobertDavid on June 8, 2006, at 13:05:22
In reply to Re: Emsan-Day 30, posted by pulse on June 8, 2006, at 10:15:04
It would appear, like most meds, it's trial and error with EMSAM. Some particularly with depression will be fine with the patch 24/7, some don't need and can't tolerate the 20mg patch and less will work best. Only option there is cutting the patch which Dr. Bodkin has indicated is okay to do.
Perhaps some will cut it in quarters. Some may just wear it in the day. I believe even if you just wear it in the day you will still have selegiline in your body as it takes 14 days to wash out, but you'll get less streamining into you're system at night which in my personal experimentation has worked.
Overall I'd think that would just mean you're at a slightly lower dose than the full patch dose, that you won't lose all theraputic benefits by taking it off. Perhpas some will want a higher dose say a 30 mgs patch in the day, and will take that off before bedtime to help with sleep while keeping a slightly higher dose during the day.
Also, so many of us know it's the blend of other meds that's the solution. I agree that the simplistic thinking that you just put it on and and you'll be fine is unrealistic for many, but for some that will work okay. For those that have had no success with other meds, playing with EMSAM dose, tweeking it, cutting it, taking it off at night, trying various techniques will be needed.
With pills, you can easily cut them in half, quarters, do multiple dosing. With the patch, the only way to do that is to cut it and take it on and off. For me, one with SP as a primary issue, I believe it's just helpful as a blend with 2mgs of klonopin.
I think it's klonopin that knocks out my SP and EMSAM gives me the energy and mood elivation (which helps me be more social). Klonopin alone was not the answer nor would EMSAM alone be. Just some food for thought.
Posted by Last Chance on June 8, 2006, at 19:14:54
In reply to Re: Emsan-Day 30, posted by RobertDavid on June 8, 2006, at 13:05:22
Rob, hi - I know you have been taking the klonapin for 12 years - now with Emsam do you still have some tired times during the day, lethargy? I drink a cup of coffee in the morning and one in the afternoon, and still have times with no energy. I realize this could be my depression, so I am concerned that more Klonopin will make me more drowsy. My .5 mg is already 4 times what I have been taking for the last 2 months. Thanx, Richard
Posted by RobertDavid on June 8, 2006, at 21:12:37
In reply to Re: Emsan-Day 30 » RobertDavid, posted by Last Chance on June 8, 2006, at 19:14:54
> Rob, hi - I know you have been taking the klonapin for 12 years - now with Emsam do you still have some tired times during the day, lethargy? I drink a cup of coffee in the morning and one in the afternoon, and still have times with no energy. I realize this could be my depression, so I am concerned that more Klonopin will make me more drowsy. My .5 mg is already 4 times what I have been taking for the last 2 months. Thanx, Richard
Richard:
I am taking 2mgs of klonopin every night. I didn't start there. As I recall I started at .5 for about a week. During that time I was wiped out, tired, some anxiety relief, but just no energy. Didn't think klonopin was right for me. But I was paying big bucks to see a Dr. that was supposed to be an expert on anxiety disorters and decided I would do my best to hang in there as long as I could on any trial he put me on. I had a tendancy before to bail quickly on med trials, but looking back did have some quacky doctors giving me the wrong meds and advise.
He soon recognized that I was very sensitive to meds, I can feel everything, am one of those that never could get up high enough on meds for them to work (or to see if they would work) because my side effects were terrible even at baby doses.
So after a week about a week he brought me slowly up in .25mg increments and as I recall I stayed at 1mg for about a month. The increased sedation which was my primary side effect of klonopin improved typically after about 2 weeks with each increase in dose. So I found myself feeling better, more social, less anxiety, but not where I wanted to be. My doctor wanted me to be close to 100% and taught me that there is "normal anxiety" in everyday living, to exect that. I/we just wanted to get rid of the SAD and GAD disorter part and he assured me in time the sedation would most likely disapear, but not the anxiety benefits. That did turn out to be the case.
Utimately the sedation and most of the mental foggyness went away, I was functioning better, but again, not quite where I wanted to be. Long story long, I moved all the way up to 3mgs, stayed there for a month. Things improved socially and I was feeling like I had never felt before, but unlike my past dose increases some of the sedation that typically went away was staying.
So I slowly dropped down and found 2mgs was the majic number for me. It took me about a year to figure that out. I've been there since and without giving you boaring details of my life, klonopin single handedly wiped out just about all my social anxiety. In fact, I had no quality of life before it, couldn't leave the house, now own a business and employ others.
Lastly, to reduce daytime sedation my doctor advised me only to take klonopin at night and suggested that with it's long half life it would give me anxiety coverage through the day, particularly once I had been taking it a while since blood levels would build up. I believe many that take klonopin in split doses should try taking the full dose at night (unless used as needed). Problem is that they try it and judge the results after only a few days, feel out of it and quit. It takes a week or more for you to get adjusted to it.
Also, for a while, the night dose will help to sleep, though in time sedation should improve concerably and I don't really think it is a factor to help me sleep any more. I used to pray that I would never have an emergency at night thinking I would be so out of it from taking all the klonopin at night, like a walking zombie, but I found that not to be the case at all. I'm in no way drugged if I have to get up during the night.
So if you're asking my opinion on why your so much more sedated now and what to do about it I'd suggest hang in there another week or two and suspect that a lot of your sedation will disapear, particularly with such a small dose. If you're taking klonopin for social anxiety then you have to find a theraputic dose or you will think the med isn't working. Most seem to end up somewhere between 1 and 4mgs if they take it for SAD and or GAD. Like other meds, you just have to deal with side effects for an initial period. For me, the majority of the out of it feeling went away and by far out weighed the benefit I was getting from anxiety relief.
Though everyone is different, EMSAM should help with energy particularly as you adjust to higher doses of klonopin. I tried to take coffee with klonopin to help with what I call the initial sedation period and some lingering sedation, but I'm so fricking sensitive that coffee makes feel amped for a few hours, then I crash and feel extreamly anxious, swear I'll never do it again.
Before EMSAM the best solution I found when I wanted some additional energy was to take a small dose of provigil (25 to 50mgs) which can be taken on a prn basis, just as needed, works day 1.
One last thing. Sleeping. If I don't sleep, it doesn't matter what I'm taking, doing, eating, work out activities, I feel tired and like crap. So I do everything I can to get sleep, as much as possible.
Anyway, I'd really consider staying at your .5mg dose for a little strech, say a week or two more and see if you're sedation improves. If it does, I'd keep going up in .25 increments until you feel the full benefit of it. It's some work and I understand just how you feel as I once did at the .5mg dose, but would hope like me, in time, you'll adjust and your world will open up (I'm assuming you're dealing primarily with anxiety and secondarily with depression).
I would be okay if I was on klonopin alone. Life would be fine. What I got from EMSAM was just the extra energy and mental clarity, treatment of a lifetime of mild depression. It's the blend that really fine tuned things.
All that said, if I had to give one up, I'd give up EMSAM. Sorry to rattle on, hope some of this is of help to you.......Rob
Posted by Jakeman on June 8, 2006, at 21:20:33
In reply to Emsan-Day 30, posted by cecilia on June 7, 2006, at 6:27:10
Hi Cecilia,
I appreciate your reports because I don't know where I'm going either with this drug. I don't have any recommedations, I just wanted to throw out some comments. It being a new drug (at least a new delivery method) I have the impression that most doctors are reluctant to recommend anything outside the manufacturer's instructions. Fortunately there is a lot of data out there about selegiline and possible augmention strategies. I think that's where we are headed eventually. There are some studies that show that l-phenylaline enhances the effect. I've had good results with combining it with Lyrica to help with sleep and anxiety. Benzos have been helpful for some people. I think we are the guinea pigs in a way. I imagine pyschiatrists and pharma reps are looking at these anecdotal reports with a lot of interest.
I also wanted to mention that I have not found Lunesta to be useless as some have mentioned. My sleep doctor has me cycling back and forth between Restoril and Lunesta. As I mentioned in a thread above, I've also benefited from taurine and tryptophan.
best of luck and warm regards, Jake
Posted by rustynail on June 9, 2006, at 7:57:02
In reply to Re: Emsan-Day 30 » cecilia, posted by Jakeman on June 8, 2006, at 21:20:33
Probably one of the biggest mistake we make in trying to adjust our meds is thinking that the dose it too low, or in this case the delivery method is not working. I dont have the luxury of trying Emsan in Australia, but i have tried nicotine patches.( They have a pretty full on way of delivering nicotine to the blood) Currently I am on Selegiline 5 mgs reduced from 15 and then 10. Less is more with this drug I am convinced. I built up from 1.25 mg to 15 mg over 2 weeks. Being very particular on watching side effects. This drug is my last hope. I have had severe insomnia all my life. Before I started to take Selegiline I was at the bottom of the bottom ready to give up. By increasing to 15 mg, one dose in the morning I was anxious in the evening and could not sleep even with Tamazapam which works well for me.I experimented with the dose and stopped cold turkey for 2 days( with side effects, dissorientation and mood swings) then went to 10MG. All the time keeping an open mind but secretly hoping the tuning I was doing was working. I had dry eyes yes.. red eyes yes for some reason??? Anyway I used the drug and decided 5 mg was a good level to keep the anxiety and the insomnia on an acceptable level.Not saying there is no anxiety but it is defiantley better and tolerable. I take tamaz every 3rd night and it definatley affects the reaction for the next day. I thought about benzo for the anxiety but I think that would defeat the purpose.The main reason I take this drug is to enable a general level of functionality and while there is not a complete feeling of wellbeing it has enbled me to function. I have learned to live with this illness and sometimes I just accept that some functionality is better than none at all. I think this is a very powerful drug and it should be treated with caution. I feel about as normal as I think I could. I also think the way the drug works is the secret and also believe that it take 4 to 8 weeks to change the chemicals in the brain. It could actually be a drug that could be used for a long term. Then again everyone is different but the other drugs that we take and even the food we eat will have some sort of effect on the outcome.
just my 2 cents worth...
Posted by cecilia on June 11, 2006, at 20:47:43
In reply to Re: Emsan-Day 30, posted by rustynail on June 9, 2006, at 7:57:02
30 days of the 20mg (6mg/24 h) patch, 3 days of the 30 mg (9mg/24h). I've given up any hope of being able to stand the 30 mg dose, or the 20 mg dose for that matter, but I just want to stick it out for 6 weeks on 20 mg just so I can tell myself I gave it a full try. I tried Robert David's trick last night, pulling off the 30 mg patch at 3:30 am and setting my alarm so I could put a new patch on at 11:30, so as to get equivalent to the 6mg/24 h. (16 hours of a 9mg/24h patch). Of course, I couldn't sleep, the stuff is still in your system, so I took an extra sleeping pill and finally got to sleep around 7:30, put the new patch on at 11:30. Taking it off before bedtime obviously isn't going to work, I'm sure it must take at least 8 hours before the blood level drops at all, there was certainly still plenty in my system when my alarm went off at 11;30. I might try taking it off 8 hours before bedtime, slapping on a new patch at bedtime along with a sleeping pill and see if that works. Then I'll try two thirds of a 30 mg patch 24 hours a day to see which way works best to get my 20 mg day, after that hopefully it'll be close enough to the 6 week mark so I can in good conscience start weaning off this lousy stuff, I'll go half a patch, 3rd of a patch, quarter of a patch etc until I'm done with this expensive box of 30 mg patches, searching along the way for any "less is more" moment when I feel less depressed, though I'm not sure how I'd know, I have no concept in my mind as to what not being depressed would feel like, though I know for sure I'll feel better once I get this horrible Emsam out of my system. It's just so discouraging, I just can't help getting my hopes up with each new med, even though I know perfectly well it's going to fail like everything else. Cecilia
Posted by Last Chance on June 12, 2006, at 11:03:56
In reply to Re: Emsan-Day 34, posted by cecilia on June 11, 2006, at 20:47:43
Cecilia - this is day 16? for me - I am having mixed and interesting results. I have been trying different dosing - it seems like really powerful stuff and at this time I cannot forsee taking more than the 20 but who knows. I have tried half patch 24 hrs - full patch 24 hrs., impossible to sleep - other combos. Now for 2 days I have been cutting a third off, putting the 2/3 on one side of my chest just below the collar bone, and the other 1/3 on opposite side. About 3 hrs. before I go to bed I remove the 2/3 and leave the 1/3 on overnight. Both nights I have slept about seven hrs., 6 without waking up - usually an impossibility for me. Good effects so far - I do feel a slight lessening of depression. It doesn't take me hrs. to wake up in the morning and I still have an expresso right away and another in the afternoon - addicted to coffee. I definitely have more focus to complete tasks, even starting them - that also has been next to impossible. More social, conversational, but with anxiety. Worst thing - I have these periods of being highly irritable - cat meows and I want to kill her. This jumpy, extremely negative anxiety has happened several times, and that is kind of scary. Road rage at that time would be really bad. Dry eyes, but not so bad that I have done anything about it. I take .25 Klonapin in the morning and evening. So I will keep trying this method for awhile and see if I stable out. Slight rise in blood pressure, also. So not bad enough to quit, and not good enough to feel like I have found the one. Richard
Posted by RobertDavid on June 12, 2006, at 12:39:20
In reply to Re: Emsan-Day 34 » cecilia, posted by Last Chance on June 12, 2006, at 11:03:56
Richard:
Perhaps you could try going up slightly on your bedtime klonopin dose to ease the agitation. Just a thought.
Posted by Donna Louise on June 12, 2006, at 20:49:16
In reply to Re: Emsan-Day 34 » cecilia, posted by Last Chance on June 12, 2006, at 11:03:56
> Cecilia - this is day 16? for me - I am having mixed and interesting results. I have been trying different dosing - it seems like really powerful stuff and at this time I cannot forsee taking more than the 20 but who knows. I have tried half patch 24 hrs - full patch 24 hrs., impossible to sleep - other combos. Now for 2 days I have been cutting a third off, putting the 2/3 on one side of my chest just below the collar bone, and the other 1/3 on opposite side. About 3 hrs. before I go to bed I remove the 2/3 and leave the 1/3 on overnight. Both nights I have slept about seven hrs., 6 without waking up - usually an impossibility for me. Good effects so far - I do feel a slight lessening of depression. It doesn't take me hrs. to wake up in the morning and I still have an expresso right away and another in the afternoon - addicted to coffee. I definitely have more focus to complete tasks, even starting them - that also has been next to impossible. More social, conversational, but with anxiety. Worst thing - I have these periods of being highly irritable - cat meows and I want to kill her. This jumpy, extremely negative anxiety has happened several times, and that is kind of scary. Road rage at that time would be really bad. Dry eyes, but not so bad that I have done anything about it. I take .25 Klonapin in the morning and evening. So I will keep trying this method for awhile and see if I stable out. Slight rise in blood pressure, also. So not bad enough to quit, and not good enough to feel like I have found the one. Richard
That is my chief complaint to, the hyper, jumpy easily agitated irritability. The thing is, I have this without medicine so I can't blame the patch, I think since it doesn't numb me out like the other drugs do, I still have my emotions. I just don't like this one at all. I have lost track how long I have been on. I think 4 weeks at 6mg and 2 weeks at 9mg. I forget about food restrictions so I haven't followed any diet although I don't eat much of anything on the bad food list anyway. I felt like I was still depressed on 6mg and I feel better on 9. I don't feel as wonderful as I did the first couple of weeks but I always feel wonderful when I first go off a drug and I had just gotten off effexor. Overall though, I love having some energy, and it is helping with both the depression and anxiety, I like it better than other all the others. I also continue to take klonopin and provigil as I think they help too. But sometimes I feel afraid and desperate because I expected to feel 100% and I don't. I see the pdoc Wed. I wonder if she is thinking lamictal like I am.
Donna
Posted by Jakeman on June 12, 2006, at 23:34:03
In reply to Re: Emsan-Day 34 » Last Chance, posted by Donna Louise on June 12, 2006, at 20:49:16
Donna,
I saw my dr. today and she mentioned the possibility of adding lamictal. But we decided to hold off until I see my sleep doctor who has me a a low dose of Lyrica...and get his opinion about maybe raising it. She also mentioned that Seroquel might be an option for sleep if it insomnia is a major problem.
I feel that Emsam has pulled me from the depths of a major depression. I tend to have an agitated depression...some of the side effects are troubling but more of just a nuisance at this point. I'm just so glad to have to some energy. Maybe I do need to get mad at times. My therapist seems to think that I much less respressed. It has not blunted my sex drive or emotions. I'm just riding the wave for now. I'm going with it for now, but I may change for whatever helps me. A work in progress? I appreciate your posts
good luck, Jake
> That is my chief complaint to, the hyper, jumpy easily agitated irritability. The thing is, I have this without medicine so I can't blame the patch, I think since it doesn't numb me out like the other drugs do, I still have my emotions. I just don't like this one at all. I have lost track how long I have been on. I think 4 weeks at 6mg and 2 weeks at 9mg. I forget about food restrictions so I haven't followed any diet although I don't eat much of anything on the bad food list anyway. I felt like I was still depressed on 6mg and I feel better on 9. I don't feel as wonderful as I did the first couple of weeks but I always feel wonderful when I first go off a drug and I had just gotten off effexor. Overall though, I love having some energy, and it is helping with both the depression and anxiety, I like it better than other all the others. I also continue to take klonopin and provigil as I think they help too. But sometimes I feel afraid and desperate because I expected to feel 100% and I don't. I see the pdoc Wed. I wonder if she is thinking lamictal like I am.
>
> Donna
>
>
Posted by cecilia on June 13, 2006, at 0:25:30
In reply to Re: Emsan-Day 34 » Donna Louise, posted by Jakeman on June 12, 2006, at 23:34:03
Well, I'm still experimenting-yesterday I cut off half the patch at bedtime and then put on a whole new patch when I got up. The Emsam folks would have a cow if they knew how many of us are experimenting with cutting patches when their drug insert says not to. (Of course I'm sure the main reason they wrote that was because they definitely don't want people saving money by cutting 40 mg patches in half to get a 2 month supply for the price of one.) All the Emsam reps reading this-we're depressed, not dumb!Emsam definitely makes me irritable, but how do you determine if that's an effect of the drug itself or the lack of sleep it causes? Cecilia
Posted by Jakeman on June 13, 2006, at 0:42:01
In reply to Re: Emsan-Day 35, posted by cecilia on June 13, 2006, at 0:25:30
> Well, I'm still experimenting-yesterday I cut off half the patch at bedtime and then put on a whole new patch when I got up. The Emsam folks would have a cow if they knew how many of us are experimenting with cutting patches when their drug insert says not to. (Of course I'm sure the main reason they wrote that was because they definitely don't want people saving money by cutting 40 mg patches in half to get a 2 month supply for the price of one.) All the Emsam reps reading this-we're depressed, not dumb!Emsam definitely makes me irritable, but how do you determine if that's an effect of the drug itself or the lack of sleep it causes? Cecilia
I don't know. Lack of sleep does not cause me irritiblity so much. I feel dumbed down, in slow motion. I suspect the irritabilty effect may relate to increased dopamine. I feel stuff like: Go ahead, get with it, Your're wasting my time. Plus increased libido.
~Jake
Posted by Donna Louise on June 13, 2006, at 12:02:46
In reply to Re: Emsan-Day 34 » Donna Louise, posted by Jakeman on June 12, 2006, at 23:34:03
.> Donna,
>
> I saw my dr. today and she mentioned the possibility of adding lamictal. But we decided to hold off until I see my sleep doctor who has me a a low dose of Lyrica...and get his opinion about maybe raising it. She also mentioned that Seroquel might be an option for sleep if it insomnia is a major problem..
depression. I tend to have an agitated depression...some of the side effects are troubling but more of just a nuisance at this point. I'm just so glad to have to some energy. Maybe I do need to get mad at times. My therapist seems to think that I much less respressed. It has not blunted my sex drive or emotions. I'm just riding the wave for now. I'm going with it for now, but I may change for whatever helps me. A work in progress? I appreciate your posts
>
> good luck, Jake
>
>
> > That is my chief complaint to, the hyper, jumpy easily agitated irritability. The thing is, I have this without medicine so I can't blame the patch, I think since it doesn't numb me out like the other drugs do, I still have my emotions. I just don't like this one at all. I have lost track how long I have been on. I think 4 weeks at 6mg and 2 weeks at 9mg. I forget about food restrictions so I haven't followed any diet although I don't eat much of anything on the bad food list anyway. I felt like I was still depressed on 6mg and I feel better on 9. I don't feel as wonderful as I did the first couple of weeks but I always feel wonderful when I first go off a drug and I had just gotten off effexor. Overall though, I love having some energy, and it is helping with both the depression and anxiety, I like it better than other all the others. I also continue to take klonopin and provigil as I think they help too. But sometimes I feel afraid and desperate because I expected to feel 100% and I don't. I see the pdoc Wed. I wonder if she is thinking lamictal like I am.
> >
> > Donna
> >
> >
>
>Damn, I just wrote this long post and lost it somehow. What did I say... oh, awhile back my pdoc suggested a microscopic dose of seroquil at bedtime for anxiety. I said no at the time, I was afraid of a neuroleptic. She thought if I took it at night the anti anxiety effects would last throughout the day. I think I would be a zombie throughout the day but maybe I should try it and I can always stop if I don't like it. I haven't had trouble sleeping but I am an oversleeper (like something from Seinfeld) but I have started taking .25mg klonopin at night since starting the patch and that may be helping, I used to just take the k during the day.
I definately agree that the dopamine is exagerating my irritability even though I have it anyway. I had expected it to help with my non existent libido but it hasn't and that is a huge disappointment.
I really appreciate your posts too, it is such a comfort to have folks in the same boat with me, not feeling alone.donna
Posted by SFY on June 13, 2006, at 17:53:43
In reply to Re: Emsan-Day 35, posted by cecilia on June 13, 2006, at 0:25:30
> Well, I'm still experimenting-yesterday I cut off half the patch at bedtime and then put on a whole new patch when I got up. The Emsam folks would have a cow if they knew how many of us are experimenting with cutting patches when their drug insert says not to. (Of course I'm sure the main reason they wrote that was because they definitely don't want people saving money by cutting 40 mg patches in half to get a 2 month supply for the price of one.) All the Emsam reps reading this-we're depressed, not dumb!Emsam definitely makes me irritable, but how do you determine if that's an effect of the drug itself or the lack of sleep it causes? Cecilia
According to my pdoc, the drug rep who brought him Emsam specifically told him that it was all right to cut the patches in half.
Posted by Donna Louise on June 13, 2006, at 18:04:13
In reply to Re: Emsan-Day 35 » cecilia, posted by Jakeman on June 13, 2006, at 0:42:01
> > Well, I'm still experimenting-yesterday I cut off half the patch at bedtime and then put on a whole new patch when I got up. The Emsam folks would have a cow if they knew how many of us are experimenting with cutting patches when their drug insert says not to. (Of course I'm sure the main reason they wrote that was because they definitely don't want people saving money by cutting 40 mg patches in half to get a 2 month supply for the price of one.) All the Emsam reps reading this-we're depressed, not dumb!Emsam definitely makes me irritable, but how do you determine if that's an effect of the drug itself or the lack of sleep it causes? Cecilia
>
> I don't know. Lack of sleep does not cause me irritiblity so much. I feel dumbed down, in slow motion. I suspect the irritabilty effect may relate to increased dopamine. I feel stuff like: Go ahead, get with it, Your're wasting my time. Plus increased libido.
>
> ~Jake
>That is exactly how I feel. I actually walked away from a friend that was asking me stupid questions in the hot sun the other day. I felt terrible about it. But I felt like if I didn't, I would either scream or slap her. Are you like this only on the patch? I am worse on the patch. something must be done. I just read a little about seroquil. I can't do anything that is going to make me sleepy all the time and crave carbs more than I already do. It is looking more like lamictal. But I am going to ask about bupe first.
donna
Posted by Jakeman on June 13, 2006, at 21:53:02
In reply to Re: Emsan-Day 35 » Jakeman, posted by Donna Louise on June 13, 2006, at 18:04:13
Donna,
I feel the irritablity but it has not gotten me into trouble. I think it has always been there under the surface. I'm sleeping half-way decently but I may investigate seroquel. At this point I'm relieved to be out of depression (most of the time) and trying to use the increased agressive feelings to my benefit. An example is my job. I have moved from a defeated feeling to more like.. this situation is pissing me off and I'm going to do something about it. I recently signed up for a career counseling program. My social life has sucked and I'm getting out a bit more. I'm thinking, if anger comes up is that a bad thing?
(someone called it the dignity emotion) For me anger comes up when I feel violated.I'm trying to meditate more too and trying to stay in touch with my gut feelings. I'm interested in your reports about lamactil or bupe. Good luck.
warm regards, Jake
>
> That is exactly how I feel. I actually walked away from a friend that was asking me stupid questions in the hot sun the other day. I felt terrible about it. But I felt like if I didn't, I would either scream or slap her. Are you like this only on the patch? I am worse on the patch. something must be done. I just read a little about seroquil. I can't do anything that is going to make me sleepy all the time and crave carbs more than I already do. It is looking more like lamictal. But I am going to ask about bupe first.
>
> donna
>
>
Posted by Donna Louise on June 14, 2006, at 6:58:56
In reply to Re: Emsan-Day 35 » Donna Louise, posted by Jakeman on June 13, 2006, at 21:53:02
My normal anger is good too, it is protective. I like that term, the dignity emotion. That is good. Mine lately is serving no good purpose. It is not the normal reaction to an injustice, ect. It is an overreaction to an irritation that feels so pathological.
I am glad that yours is appropriate and that you can use it to improve your quality of life. That is what it is for and it is cool that you are getting this opportunity. The meditation is a great idea, I use to do that and got good results. Now I fall asleep as soon as I sit in a chair and start to relax. Maybe I should do it standing on my head. No, then I would probably get a stupid migraine.
I can't wait to see the pdoc today. I will let you know the upshot of the visit.donna
> Donna,
>
> I feel the irritablity but it has not gotten me into trouble. I think it has always been there under the surface. I'm sleeping half-way decently but I may investigate seroquel. At this point I'm relieved to be out of depression (most of the time) and trying to use the increased agressive feelings to my benefit. An example is my job. I have moved from a defeated feeling to more like.. this situation is pissing me off and I'm going to do something about it. I recently signed up for a career counseling program. My social life has sucked and I'm getting out a bit more. I'm thinking, if anger comes up is that a bad thing?
> (someone called it the dignity emotion) For me anger comes up when I feel violated.
>
> I'm trying to meditate more too and trying to stay in touch with my gut feelings. I'm interested in your reports about lamactil or bupe. Good luck.
>
> warm regards, Jake
>
>
> >
> > That is exactly how I feel. I actually walked away from a friend that was asking me stupid questions in the hot sun the other day. I felt terrible about it. But I felt like if I didn't, I would either scream or slap her. Are you like this only on the patch? I am worse on the patch. something must be done. I just read a little about seroquil. I can't do anything that is going to make me sleepy all the time and crave carbs more than I already do. It is looking more like lamictal. But I am going to ask about bupe first.
> >
> > donna
> >
> >
>
>
Posted by cecilia on June 14, 2006, at 7:26:28
In reply to Re: Emsan-Day 35 » Donna Louise, posted by Jakeman on June 13, 2006, at 21:53:02
Well, the taking the patch off at bedtime and taking it off 8 hours before bedtime definitely don't work, once this stuff is in your system it's IN. I HATE Emsam (and every other med I've taken, all the money I've spent for horrible side effects and no benefits.)!!!!!!!!!! I don't understand why pdocs are allowed to stay in business. "Real" meds work. You take a BP med and your blood pressure goes down. You take an antibiotic and your infection goes away. But I've taken every AD there is and never gotten ANYTHING but unpleasant side effects. Cecilia
Posted by ZeitGuest on June 14, 2006, at 12:36:50
In reply to Re: Emsan-Day 36, posted by cecilia on June 14, 2006, at 7:26:28
My irritability levels are way up above normal. Little frustrations set me off to a degree that's out of proportion to the inciting annoyance. Also, I'm having trouble emotionally rebounding from these reactive states. For example, after hearing some bad news about a criminal investigation of Washington politicos yeserday, I went into a depressive funk that lasted much longer than I think it normally would have.
I've recently increased my dose of Emsam from 6mg to 9mg. I'll let you all know how that works.
P.S. I'm going to start appending my posts with my current "Emsam Stats." In reading other people's posts on this board, I find it hard to keep track of how long posters have been on the patch, at what level, and which augmentation drugs they are taking. I encourage others to post their own current stats at the bottom of each post so that we can match the "symptoms" described to the dose history. Just a suggestion....
*My Emsam Stats*
Day 41: 39 days w/ 6mg patch, 2 days w/ 6mg + 3mg (1/2 patch)
Other Meds: None
Posted by Declan on June 14, 2006, at 14:24:19
In reply to Re: Emsan-Day 35 » Jakeman, posted by Donna Louise on June 14, 2006, at 6:58:56
For me anger has been the cure for fear. No idea why, of course.
Posted by Declan on June 14, 2006, at 14:27:30
In reply to Re: Emsan-Day 36, posted by cecilia on June 14, 2006, at 7:26:28
Is it that real meds treat real diseases and depression is a symptom cluster, caused by God knows what?
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