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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Donna Louise on July 7, 2006, at 1:41:12
In reply to Re: Emsam and Attention Problems?, posted by Another Phil on June 28, 2006, at 15:12:03
> > 1 - Dexedrine/EMSAM/Attention - Did you consider >reducing< your dexedrine dose to see if that helped? One of EMSAM's metabolites is itself an amphetamine, and maybe the stimulation producing by EMSAM and/or this metabolite is revving you up so much that you're more distracted than you were without any drugs. I know when I really upped my Dexedrine doses I was overexcited and distractable, maybe your combo is producing net negative effects at previously effective doses.
> >
> > 2. Effexor - Combining MAOI's with other ADs that affect serotonin is contraindicated to guard against "serotonin syndrome". I know effexor targets Serotonin (and norepinephrine), which would seem like the basis for contraindication. while I've seen doctors try contraindicated combos (MAOIs & wellbutrin, MAOIs TCAs), usually this is for treatment resistant conditions or to counteract side effects. Given that the MAOI SSRI prohibition is one rather religiously adhered to, I would personally be wary of combining Effexor EMSAM given the risks. On the other hand, a qualified psychophamarcologist should know what they're doing...
>
> Actually, I've considered both of these. I often skip doses of Dexedrine on the weekend when I don't have much "thinking" work to accomplish. There hasn't been any effect on my ability to concentrate (as measured by my tendency to go from task-to-task on one long endless tangent).
>
> #2 is the primary reason why I had been trying to wait it out for a while after Effexor withdrawal. However, my depression has gotten bad enough again that I don't think that's a good idea. After consulting with my psychopharmacologist yesterday, I've started tapering up on Parnate and stopping Emsam. Already, I'm experiencing the Parnate-induced insomnia (even at my starting dose of 10 mg). So, thanks for your help, but I think that since my mood was so good on Emsam that I waited too long to address the attention problems. In the intervening time, I've ignored dealing with some really important logistical issues in my life that just can't wait any longer.
>
> I've been on pretty much every antidepressant (or, at least, representatives from each class). All have either had intolerable side effects or insufficient antidepressant effect. I did have a pretty good stretch (mood-wise) on Parnate many years ago, but stopped because the insomnia was making me unable to function. So, I hope my current doc can help me come up with an acceptable solution for the insomnia.
>
> Thanks again.
>
> Phil
Hi Phil, I too had to do the effexor withdrawal which I did for a week before starting emsam. I am thinking it could be the effexor withdrawal giving you problems. My withdrawal was truly a nightmare from hell and I had all kinds of mental and physical dysfunctions, to put it mildy. Once all that cleared, I find my mental clarity better than it has been in a long time. One of the things the sri's did to me was muddy the mental waters.donna
Posted by Another Phil on July 7, 2006, at 1:41:12
In reply to Re: Emsam and Attention Problems? » Another Phil, posted by Donna Louise on July 2, 2006, at 6:03:10
> Hi Phil, I too had to do the effexor withdrawal which I did for a week before starting emsam. I am thinking it could be the effexor withdrawal giving you problems. My withdrawal was truly a nightmare from hell and I had all kinds of mental and physical dysfunctions, to put it mildy. Once all that cleared, I find my mental clarity better than it has been in a long time. One of the things the sri's did to me was muddy the mental waters.
>
> donna
>Donna,
Actually, I didn't go off of Effexor until very recently. So, it definitely wasn't withdrawal causing my attention problems. For me, now, the point is now moot, since I switched from Emsam to Parnate. I don't think I've *ever* been as not-depressed as I've been since starting on Parnate. There are still some side-effect issues I need to work out, but I'm feeling great (so good, in fact, that the onerous dietary restrictions don't bother me anymore).
Thanks for your help though.
Phil
Posted by Donna Louise on July 7, 2006, at 1:41:12
In reply to Re: Emsam and Attention Problems?, posted by Another Phil on July 5, 2006, at 22:11:05
> > Hi Phil, I too had to do the effexor withdrawal which I did for a week before starting emsam. I am thinking it could be the effexor withdrawal giving you problems. My withdrawal was truly a nightmare from hell and I had all kinds of mental and physical dysfunctions, to put it mildy. Once all that cleared, I find my mental clarity better than it has been in a long time. One of the things the sri's did to me was muddy the mental waters.
> >
> > donna
> >
>
> Donna,
>
> Actually, I didn't go off of Effexor until very recently. So, it definitely wasn't withdrawal causing my attention problems. For me, now, the point is now moot, since I switched from Emsam to Parnate. I don't think I've *ever* been as not-depressed as I've been since starting on Parnate. There are still some side-effect issues I need to work out, but I'm feeling great (so good, in fact, that the onerous dietary restrictions don't bother me anymore).
>
> Thanks for your help though.
>
> Phil
That is great news! How rare and wonderful around here to find something that is really working without too many offsetting side effects. I feel like I always have nardil in my back pocket just in case after hearing how many who are otherwise not helped get some relief with it. I don't care about the diet, the only thing that would effect me is the tofu and I sure wouldn't pass up feeling better for a little tofu..
Congratulations!dpmma
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