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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by chiron on March 26, 2007, at 21:10:51
Wow, just a few weeks ago I was saying anxiety isn't one of my normal issues. But I think it is creeping up on me because I am feeling freaked out to be alone. I woke up Saturday morning and called my mom right away. I ended up spending most of the day with her even though she irritates me. I hate this feeling. Along with a constant feeling of instability.
Does the 9mg help or usually just make it worse?
Posted by Phillipa on March 26, 2007, at 22:03:54
In reply to Emsam increasing Anxiety?, posted by chiron on March 26, 2007, at 21:10:51
Robert Davids answer was klonopin. Love Phillipa
Posted by UgottaHaveHope on March 26, 2007, at 23:23:09
In reply to Re: Emsam increasing Anxiety? » chiron, posted by Phillipa on March 26, 2007, at 22:03:54
From what I have read and what I have personally experienced, Emsam does nothing for anxiety. It is like prozac, designed to give you an energy boost. You may want to augment with Klonopin.
Posted by Honore on March 27, 2007, at 0:06:44
In reply to Re: EMSAM apparently is not for anxiety, posted by UgottaHaveHope on March 26, 2007, at 23:23:09
I don't particularly agree that Emsam isn't good for anxiety, because I'm much less anxious now than before using it. It does cause some temporarily increased anxiety/agitation at first, perhaps, especially if you increase the dose too fast.
But I would augment with xanax or something else to relieve the anxiety if you feel more. At least for a while. You may find that a lot of things are much easier to do, in the long run.
Honore
Posted by chiron on March 27, 2007, at 7:44:35
In reply to Re: EMSAM apparently is not for anxiety, posted by Honore on March 27, 2007, at 0:06:44
Thanks for the advice. How long until your anxiety subsided? Did it also improve your mood? Sense of stability (I'm also feeling really unstable right now).
Posted by UGottaHaveHope on March 27, 2007, at 8:01:02
In reply to Re: EMSAM apparently is not for anxiety, posted by Honore on March 27, 2007, at 0:06:44
Honore: What patch dosage are you taking? And are you augmenting it with anything? Thanks, Michael
Posted by Honore on March 27, 2007, at 10:16:20
In reply to Re: Honore Q about Emsam » Honore, posted by UGottaHaveHope on March 27, 2007, at 8:01:02
I'm using a 12 mg patch. I think I'm going to experiment with taking it off at night for four or five hours. I'm not sleeping that well,and also I think my mood is a little smoother on 9 mg. total. (That's a hypothesis that I want to look into anyway.)
I'm also taking 2.5 mg abilify and 200 mg provigil, and occasional xanax for anxiety. Also small amounts of seroquel for sleep. Not totally effective; I might need more, but am a little hesitant to go up-- I may, I'm not sure.
I use the provigil because I've never slept well, and it's always helped with daytime tiredness, which I still have with the patch. I do have a lot more energy though, overall.
I was taking provigil and xanax before; in fact I'm using less xanax now than I have at various points.
I'm also doing things I never would be able to do without Emsam-- going to class, going out with people-- doing more work. Even though I have times of transient anxiety or panicky reactions-- I always did, but they have a particular quality with Emsam--my overall anxiety level is much lower. Or I wouldn't be doing these things that usually send me into endless anxious ruminations and paralyzing fears.
I'm not saying it would work for everyone-- although I suspect the MAOIs are the best ADs, in general, and should be tried much more.
For me, this is as close as I've come to having any kind of real life, since I was a pre=adolescent and got seriously depressed. So I'm pretty impressed-- and wish others could find something like this. I also, of course, hope it lasts.
Honore
Posted by Honore on March 27, 2007, at 10:26:26
In reply to Re: EMSAM apparently is not for anxiety » Honore, posted by chiron on March 27, 2007, at 7:44:35
I had a fair amount of anxiety at the beginning, which became extremely problematic when I had a large dose on during the day-- because I was taking it off at night.
I reduced my daytime dose and actually did much better overall on a lower dose.
I'd say the first time around, because I was increasing the amounts during the day to a high amount (18 mg/12 hours; 0 mg/12 hours to equal nine mg), it's hard to say when my anxiety would have tapered off if I hadn't done that.
When I went back to about 6-9 mg (a schedule of 16-18 hours of 12 mg; and 6-8 hours of 0 mg), the anxiety subsided almost immediately.
I could speculate that there' s a tendency to go up too fast, and maybe to use too much Emsam. I do think it takes a little longer to come to full effect than maybe is thought-- although I had some noticeable reaction to it after about 10 days. Not huge, but definitely there.
I'd say the anxiety peaked for me at about 6 weeks (at the high dose) and fell as soon as I realized I was feeling really embattled and internally in turmoil from it. So it could take a while--although probably not that long. My use was atypical, so I"m not sure.
I had lesser anxiety that was in the background and sometimes became more intense, during the first weeks, definitely. Also insomnia, which is still a problem (but has always been a problem for me).
Give it time. I also was using xanax, which I recommend, to moderate the anxiety that may be inevitable.
For me at least, as I was saying, this time around abilify really reduced the anxiety level, at a low dose. At a slightly higher dose, it also seemed to make me more edgy and impatient.
Honore
Posted by greywolf on March 27, 2007, at 20:44:28
In reply to Re: EMSAM apparently is not for anxiety » chiron, posted by Honore on March 27, 2007, at 10:26:26
I'm at 6mg Emsam and have experienced no increase in anxiety that I can attribute to Emsam. Perhaps there's a greater incidence of anxiety at higher dosages that would warrant a lower dose with augmentation or a longer ramping up period to the higher dose. Is there a way to gradually go from 9 to 12? I'm not sure there is. You might be stuck with using a benzo in addition to the Emsam.
This is the end of the thread.
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