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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by greywolf on May 8, 2007, at 18:53:33
Just about to start Emsam 12mg/day. I've been on 6mg and 9mg for the last couple months with no side effects, but no noticeable benefits either. I'm hoping for something soon because my doctor says we've exhausted all the meds when I'm done with this.
Posted by Declan on May 8, 2007, at 19:11:09
In reply to About to start Emsam 12mg, posted by greywolf on May 8, 2007, at 18:53:33
You've had no insomnia (or lightening of sleep) up till now?
Posted by greywolf on May 8, 2007, at 22:10:42
In reply to Re: About to start Emsam 12mg » greywolf, posted by Declan on May 8, 2007, at 19:11:09
Some minor increase in insomnia--but I already had it pretty bad prior to starting Emsam.I have noticed a small increase in agitation, but nothing major.
Overall, Emsam so far is less effective for me than Nardil. I like the convenience of a once a day patch, but the therapeutic effect has yet to kick in. That's not a surprise, and maybe it will help to go to 12mg. I hope so, because the only thing left is either ECT or VNS.
Greywolf
Posted by Phillipa on May 8, 2007, at 22:45:24
In reply to Re: About to start Emsam 12mg » Declan, posted by greywolf on May 8, 2007, at 22:10:42
Greywolf I hope it kicks in for you. You deserve it to work for you. Love Phillipa
Posted by greywolf on May 9, 2007, at 4:07:53
In reply to Re: About to start Emsam 12mg » greywolf, posted by Phillipa on May 8, 2007, at 22:45:24
Thanks, Phillipa.
I'm hoping it works, but I won't hold my breath. It's been many, many years of every med you can imagine, but no real relief. The psychiatrist I'm seeing now is known to be very aggressive with meds, so it's somewhat daunting to hear him say I'm at the end of the road in terms of pharmaceutical options.
I've already done the therapy thing for depression without success. I'm currently in bi-weekly therapy for OCD, but that doesn't have much to do with my depression problems. ECT is not really an option, as even my psychiatrist points out, because of the nature of my work. So, VNS is it if Emsam doesn't work out.
I'm a little concerned about the efficacy of VNS. It's FDA-approved, and it has few side effects (other than having a pacemaker permanently implanted in your chest), but I have not seen anything clearly establishing its efficacy.
I guess I'm stuck. I've been doing everything I can to keep on top of my work because I don't want to interrupt my career. I had to take several months off about 7 years ago, and I really don't want to put my family in that position again. So, if Emsam doesn't work, I'll do the VNS even if it hasn't been proven yet.
Greywolf
Posted by greywolf on May 9, 2007, at 4:08:37
In reply to Re: About to start Emsam 12mg » greywolf, posted by Phillipa on May 8, 2007, at 22:45:24
Thanks, Phillipa.
I'm hoping it works, but I won't hold my breath. It's been many, many years of every med you can imagine, but no real relief. The psychiatrist I'm seeing now is known to be very aggressive with meds, so it's somewhat daunting to hear him say I'm at the end of the road in terms of pharmaceutical options.
I've already done the therapy thing for depression without success. I'm currently in bi-weekly therapy for OCD, but that doesn't have much to do with my depression problems. ECT is not really an option, as even my psychiatrist points out, because of the nature of my work. So, VNS is it if Emsam doesn't work out.
I'm a little concerned about the efficacy of VNS. It's FDA-approved, and it has few side effects (other than having a pacemaker permanently implanted in your chest), but I have not seen anything clearly establishing its efficacy.
I guess I'm stuck. I've been doing everything I can to keep on top of my work because I don't want to interrupt my career. I had to take several months off about 7 years ago, and I really don't want to put my family in that position again. So, if Emsam doesn't work, I'll do the VNS even if it hasn't been proven yet.
Greywolf
Posted by Honore on May 9, 2007, at 8:31:45
In reply to Re: About to start Emsam 12mg » Phillipa, posted by greywolf on May 9, 2007, at 4:08:37
Have you tied Abilify or Geodon?
Alone, or as augmentation of other ADs? Or other augmenters for other ADs, like lithium, lamictal? Or combinations of ADs?
Honore
Posted by greywolf on May 9, 2007, at 9:25:34
In reply to Re: About to start Emsam 12mg » greywolf, posted by Honore on May 9, 2007, at 8:31:45
Honore,
I haven't tried Abilify or Geodon. The doctor is reluctant to go with Abilify because it can be activating, which could be a problem with my manic phase. I have not explored Geodon.
Here's a partial list of what I've been on at a therapeutic dose: Seroquel, Zyprexa, Nardil, Emsam, Paxil, Prozac, Wellbutrin, Serzone, Remeron, Effexor, Lexapro, Celexa, Lamictal, Depakote, lithium, Cymbalta, Symbyax, Luvox, desipramine, imipramine, doxepin, trazodone, Zoloft, Anafranil. I've taken these meds as monotherapy and augmented. Add in Xanax and Klonopin for anxiety.
There are several others I can't recall, but that's the general outline. There are meds in certain classes that I haven't tried, but that's probably because I didn't have success with one or more other meds in the same class.
Greywolf
Posted by Phillipa on May 9, 2007, at 19:11:58
In reply to Re: About to start Emsam 12mg » Honore, posted by greywolf on May 9, 2007, at 9:25:34
Greywolf such a lot of meds Parnate too? and resperidol? And ever anything like providgil? Love Phillipa
Posted by stargazer on May 9, 2007, at 19:37:13
In reply to Re: About to start Emsam 12mg » Honore, posted by greywolf on May 9, 2007, at 9:25:34
Have you thought about taking part in one of these? (clinicaltrials.gov)
Two meds currently being lookied at for TRD are Ketamine and Riluzole.
I too take Emsam and went from 6 to 9 to 12, back to 6 and added Abilify for energy, which was helpful. Then I added amphetamine for focus and energy but I saw a doc and discussed the above meds so they may be next.
Perhaps before VNS look into them too.
Stargazer
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