![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Bandaid9 on October 6, 2007, at 1:15:02
Has anyone gone over the 12 mg dose? Emsam has worked well for me for the past year, but I have had to gradually increased the dose - I'm now on 18 mg. Also, my psychiatrist said that the clinicl trials didn't require the patients to use the MAOI diet even at the 12 mg dose. Now he says I'd better stick to the diet. Has anyone had trouble cheating on the diet?
Posted by d0pamine on October 6, 2007, at 4:38:58
In reply to Emsam dosage, posted by Bandaid9 on October 6, 2007, at 1:15:02
I eat a veterinarian diet anyway, so part of the recommended diet comes pretty natural, however. I ordered a case of Bragg's Organic vinegarette salad dressing and tried some on a salad and came down with one of the worst headaches I've ever had. My bp was 160/102 which isn't critical, but was apparently bad enough to make my head pound. This was likely due to the "Bragg's liquid aminos" that are included in the dressing "for taste". This is the only real trouble that I've ran into in the nearly two years on emsam.
Posted by stargazer2 on October 6, 2007, at 8:50:01
In reply to Emsam dosage, posted by Bandaid9 on October 6, 2007, at 1:15:02
That's alot of Emsam! I never heard of going above the 12 mg dose, does your doctor do this routinely with his patients? How are you able to pay for the Emsam when I'm sure insurance companies would question why you are on more than the prescribed dosage. I thought the patch at the scheduled doses ran about $500/month. Many people on it were unable to afford it if they did not have insurance.
I took it earlier this year and had some minor glitches getting coverage but I would think they would never pay for more than 12 mg at a time.
How are you doing on it at that level? The diet was recommended at 9 mg and over but I believe the incidence of a hypertensive reaction was relatively rare, but since your level is double the normal dose you better follow the diet strictly just in case.
I had a hypertensive reaction earlier this year (on Nardil and a 10 mg dose of Amphetamine salts) and my BP was 230/130, and I handled it at home with my Nifedipine pills and BP cuff.
A very scarey experience though. I never want to go through that again but I know to be aware of it happening when least expected, except I don't take the Nifedipine or cuff with me when I'm out.
Stargazer
Posted by johnj on October 6, 2007, at 10:06:19
In reply to Re: Emsam dosage/Bandaid9, posted by stargazer2 on October 6, 2007, at 8:50:01
Hello:
May I ask what you take nardil for? I have anxiety/ocd and ssri's and benzo's make me feel horrible. I was wondering if nardil might work for me but was worried about insomnia as that is my problem most of the time due to anxiety. Did you have insomnia problems on nardil? Thank you.
johnj
Posted by Phillipa on October 6, 2007, at 12:15:18
In reply to Re: Emsam dosage/Bandaid9, posted by stargazer2 on October 6, 2007, at 8:50:01
No way I could afford it and never heard of anyone going above l2mg does this means it poops out like all the other meds seem to? Phillipa
Posted by d0pamine on October 6, 2007, at 15:57:59
In reply to Re: Emsam dosage/Bandaid9 » stargazer2, posted by Phillipa on October 6, 2007, at 12:15:18
I've experienced ZERO tolerance issues with EMSAM. If anything, sometimes I feel like the doses become cumulative after a while.
Posted by Brody on October 6, 2007, at 16:43:45
In reply to Re: Emsam dosage/Bandaid9, posted by d0pamine on October 6, 2007, at 15:57:59
> ...... If anything, sometimes I feel like the doses become cumulative after a while. >
>
That's interesting.... I have recently been thinking that as well.This makes me feel it is even more important that new users stay with it for a good long trial. (assuming, of course, the side effects are workable... I had a relatively easy time of it.)
Also, after reading several of your posts on the topic, I tried and found that Provigil works better for me when taken on an "as needed" rather than daily basis.
Thanks for posting your thoughts.
Janet
Posted by Bandaid9 on October 6, 2007, at 22:04:34
In reply to Re: Emsam dosage » d0pamine, posted by Brody on October 6, 2007, at 16:43:45
I'm surprised that no one has gone over the 12 mg dose. I also take a high dose of Abilify - 30 mg. Regarding the Emasam cost, my insurance covers it as one dose, so I pay $45/month.
Posted by Phillipa on October 6, 2007, at 22:06:24
In reply to Re: Emsam dosage, posted by Bandaid9 on October 6, 2007, at 22:04:34
Good insurance unfortunately I have Disability. Phillipa
Posted by d0pamine on October 7, 2007, at 1:43:07
In reply to Re: Emsam dosage, posted by Bandaid9 on October 6, 2007, at 22:04:34
I'm just blown away by the 18mg. EMSAM strikes me as some pretty potent stuff at 12. Are you able to sleep at all?
Posted by d0pamine on October 7, 2007, at 1:51:41
In reply to Re: Emsam dosage » d0pamine, posted by Brody on October 6, 2007, at 16:43:45
That's cool that the Provigil is working better when taken like that. I think it's some great stuff when used that way. I personally find it very helpful for recovering from occasional "EMsomnia" (tm).
Posted by Bandaid9 on October 7, 2007, at 16:16:34
In reply to Re: Emsam dosage, posted by d0pamine on October 7, 2007, at 1:43:07
Sleep is hard - I take 4 mg Klonopin each night. Even that doesn't get me a good night's sleep.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.