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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JohnSky on July 3, 2007, at 11:17:06
Hello.
I started EMSAM 5 days ago and many times during the day I feel intense anxiety. I also have not been sleeping well as my mind races in my dreams and I wake up tired.
My question: Is increased anxiety and agitation a start up effect others have had to deal with and does it taper off? My doc tells me the anxiety (near panic at times) will fade away in 7 to 14 days and the the insomnia will get better as well. I would love to hear from others
that have experienced these side effects.Nardil really helped me years ago with depression and anxiety and I am dearly hoping this "cousin" to Nardil will help me... I've tried all the SSRIs. So I am willing to deal with the start up side effects if they do start to fade away in another 5 days or so... I can't take much more than that to be honest. I am very sensitive to meds and so many that I have tried blast me with anxiety initial.
Thanks in advance for the help.
John
Posted by d0pamine on July 3, 2007, at 11:44:55
In reply to EMSAM start up side-effects, posted by JohnSky on July 3, 2007, at 11:17:06
For me the first 3 weeks were fairly asymptomatic all the way around but by week 4 the insomnia was starting while still providing no positive effects. By the end of week six however I began to become a different person. Although I still experienced the insomnia and a few other fairly benign effects, by week 8 I was alive and functional and basically what I’d consider to be normal. I’ve now been using EMSAM (12mg/24 (the big patch)) for about 1.5 years and thank God for it on a daily basis as there is simply no comparison to life without it. I’ve read numbers of stories of people who stop taking it because it isn’t helping them, however I suspect that in the majority of cases they simply didn’t use a large enough patch for a long enough period of time. If you find the side effects intolerable I suppose that’s a different story, but if that isn’t the problem, make sure you give it a good 8 week fair shot as I’ve tried pretty much everything out there and for me, there is nothing like it. My experience has been that some of the quirky side effects will likely go away with time (taste perversion, jitters, anxiety (unless you’re just prone to that naturally)), but some of the side effects will get worse for the first 6 months until they plateau (primarily insomnia)). However just in the last 4 weeks I’ve found a complete 100% cure for my insomnia and have gone from sleeping 2 to 4 hours / night to as many as I have time for. 700 Mg X 2 / day of Potassium Citrate (has to be citrate). I should note that the RDA on potassium is somewhere around 3,200 Mg however because it is so potentially dangerous, supplements have been limited by the FDA to 99Mg so I have to take 14 of them a day to get that dose. In some situations potassium overdose can occur and can very quickly result in cardiac arrest followed shortly by death, so you’d likely want to discuss such a supplement with your healthcare professional prior to consumption. Potassium is serious stuff, too little and you die, too much and you die. Best of luck
Posted by Phillipa on July 3, 2007, at 12:09:37
In reply to Re: EMSAM start up side-effects » JohnSky, posted by d0pamine on July 3, 2007, at 11:44:55
Football wanted to compliment you on you excellent advise concerning supplementation as It's very true. But I thought you were on Nardil? Love Phillipa
Posted by Phillipa on July 3, 2007, at 12:12:39
In reply to Re: EMSAM start up side-effects » d0pamine, posted by Phillipa on July 3, 2007, at 12:09:37
Sorry I meant dopamine and it's not you on the nardil but I've heard as was going to try EMSAM as well and even have samples to try that klonopin helps enormously with insomnia due to EMSAM. But still an excellent reply forgive my ignornance. Love Phillipa
Posted by KayeBaby on July 3, 2007, at 12:16:25
In reply to EMSAM start up side-effects, posted by JohnSky on July 3, 2007, at 11:17:06
> Hello.
>
> I started EMSAM 5 days ago and many times during the day I feel intense anxiety. I also have not been sleeping well as my mind races in my dreams and I wake up tired.
>
> My question: Is increased anxiety and agitation a start up effect others have had to deal with and does it taper off?
**Yes. I did not have the anx. and insomnia nearly as bad as some people do. It does go away in a couple of weeks give or take a week. For me the really good effects of EMSAM took about 5-6 weeks to manifest. But is is great! I don't feel like I an "on" anything. Just chipper. I added Namenda about 5 weeks after I started EMSAM so it's hard tto know which on to give the most credit to. I think EMSAM is well augmented by the addition of Namenda and I noticed my sleep improved after starting it.
My doc tells me the anxiety (near panic at times) will fade away in 7 to 14 days and the the insomnia will get better as well. I would love to hear from others
> that have experienced these side effects.
>
> Nardil really helped me years ago with depression and anxiety and I am dearly hoping this "cousin" to Nardil will help me... I've tried all the SSRIs. So I am willing to deal with the start up side effects if they do start to fade away in another 5 days or so... I can't take much more than that to be honest. I am very sensitive to meds and so many that I have tried blast me with anxiety initial.
>
> Thanks in advance for the help.
>
> John**Get a Rx for a sleep aid or benzo to help you through this time. It would bena shame for you to give up too soon.
Kaye
Posted by JohnSky on July 3, 2007, at 13:36:54
In reply to Re: EMSAM start up side-effects » JohnSky, posted by d0pamine on July 3, 2007, at 11:44:55
Thank you all for your quick and informative posts. I am doing my best to "hang in there" with this intense anxiety and not give up on the EMSAM. My gut tells me the medication will help me down the road. At times I get so anxious and aggitated I want to throw the medication in the trash and forget it. I always seem to have alot of anxiety starting most medications... I am just very sensitive. I am using Lorazepam and a low does of Gabapentin to help get me through this phase. I've never heard of Namenda.
Would love to hear from more people that had anxiety and agitation when starting the medication to give me more confidence in staying with it. I realize no one can tell me when the anxiety will back up as we are all chemically unique but it would be great to see if the max for the anxiety is usually two weeks. I'm praying that in a couple days the anxiety will start to come down
John
Posted by Seeking Peace on July 3, 2007, at 14:10:07
In reply to Re: EMSAM start up side-effects, posted by JohnSky on July 3, 2007, at 13:36:54
I started off on the 9mg patch. Got severe anxiety and insomnia got worse too. already had insomnia before emsam. I too wanted to throw it far away from me. I decided after 3 days to just start cutting off patch...went from half to slowly full. Told pdoc too. She just wanted me to leave it on at night too even if i was going to chip off some of it. The gradually going up helped me some with anxiety. Insomnia no. anxiety went away 2 wks later or so. 3rd wk on emsam, one night suddenly slept better, 2nd night too.
I kind of messed my schedule after that and then fact i was traveling etc. So my sleep got bad again and so did anxiety. I'm in wk 6 or so. Decided to quit, can't reach pdoc as away on vacation. My depression is not better, so I don't think it's for me.
maybe u can try the gradual method too. Did u start on 6 or 9 mg? I hope it works for you....
good luck
Seeking peace
Posted by d0pamine on July 3, 2007, at 14:23:31
In reply to Re: EMSAM start up side-effects, posted by JohnSky on July 3, 2007, at 13:36:54
If you are already experiencing “intense anxiety”, then EMSAM may well not be for you. If it fades, it will be very slowly. Any anxiety that I developed only increased during the first 6 weeks before reaching a plateau and pretty much remaining at the same level from then till now. In my case however this wasn’t altogether unwelcome, as my pre-EMSAM anhedonic, lethargic condition needed a swift kick. Make sure you’re not taking any supplements or protein drinks with amino acids (some cause problems some don’t), ephedrine, caffeine, or phenylethylamine (as in chocolate) or any of the like in them as their anxiety producing tendencies are greatly amplified by the inhibition of MAO.
This is the end of the thread.
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