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Re: EMSAM - insurance and dosage ?s » tygereyes

Posted by RobertDavid on April 11, 2006, at 22:29:47

In reply to EMSAM - insurance and dosage ?s, posted by tygereyes on April 11, 2006, at 21:44:21

> Also, how long do I have to be off of Parnate before I start Emsam? I'm having such a hard time getting off of Parnate. I am truly addicted to it. I will be the first person to defend psychotropic medication (after all, I am studying to be a psychiatrist!) as generally non-addictive but I can no longer kid myself here. I can't take Parnate just like I can't take benzodiazepines - I will abuse the hell out of it. I don't know how I'm going to be able to stay off of it for two weeks, when I still have so many pills here and start feeling that "crashing" feeling every time I stop taking it. How bad would it be, exactly, if I didn't have a wash-out period between Parnate and Emsam?
> And finally, what dose of Emsam is comparable to 80 mg Parnate? I have always needed to take higher doses of anti-depressants than recommended by the FDA - will I actually be able to start out at a higher dose or (like with oral medications) will I need to start on a lower patch and then go up higher gradually?

I found this on the BMS website. Perhaps based on the half life of Parnate you can figure out how long to wait:

After stopping treatment with SSRIs; SNRIs; TCAs; MAOIs; meperidine and analgesics such as tramadol,
methadone, and propoxyphene; dextromethorphan; St. John’s wort; mirtazapine; bupropion HCl; or buspirone HCl, a time period equal to 4-5 half-lives (approximately 1 week) of the drug or any active metabolite should elapse before starting therapy with EMSAM.

Otherwise I suppose it's just up to you and your doctor to choose the 20, 30 or 40mg dose. I haven't read anything anywhere that suggests any minimum starting dose. You're not supposed to use more than one patch (and who would want to at that price) so it seems you've just got 3 options. I started at the 20mg dose.

Best of luck! Rob




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