Posted by Crazy Horse on July 1, 2006, at 19:01:26
In reply to 3 months on EMSAM - My take on it, posted by RobertDavid on July 1, 2006, at 16:07:04
> Hello all. I haven't been following the posts, but I thought I give an update and my take on EMSAM.
>
> First let me say that my primary disorters are SAD, GAD and mild depression (in order). I have taken klonopin for SAD & GAD for over 12 years (I'm taking 1.75mgs at night). Klonopin is the only thing I've ever taken that works, and it works good.
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> But through the years being on klonopin I always felt a litte depressed and didn't have much zest for life, low energy so I tried adding numerous meds without luck (other than some help with low dose provigil 50gs taken as needed). I've always been a little depressed so I'm not sure how much of it was a side effect from my anxiety disorters or how much was agrrivated from taking a benzo. Probably a combo of the two. I guess it doesn't matter as without klonopin, I could hardly leave the house and know that would still be the case without it.
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> So over the last 3 months I've been on EMSAM. I felt a quick burst of energy taking the 20mg patch 24/7 when I first took it back in April. I got more done, was more upbeat and particularly noticed that my mental clarity improved.
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> But as it built up in my system I wasn't sleeping as well (but, I have never slept well). When I don't sleep well, I don't feel good, period. At times the lack of sleep made me slightly agitated, but still overall was feeling much better. No doubt klonopin has helped with agitation.
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> So after talking with my pdoc and writing to Dr. Bodkin, a researcher with the EMSAM studies I decided to play with the patch, cutting it in half and on occation taking it off at night. I did all kinds of variations to try to fine tune it.
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> I've found all I need is half a 20mg patch. Though I am now sleeping more normally perhaps because my body has adjusted to it as well as the lower 10mg dose, on occation I still take it off at night, usually on the weekends. Doing that doesn't seem to have any effect on the benefits I get from it and I do sleep a little better. I have no longer have the need to take a sleeping pills at night. I also think my sleeping has improved because I work out at the gym more as a result of the increased energy from EMSAM.
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> My conclusion is that EMSAM will certainly not be for everyone. That it's probably best for those that are dealing primarily with depression and have failed to respond to SSRI's as well as those like me who have primary anxiety disorters who are also taking an adequate dose of klonopin or other benzo as I'm certain the benzo makes EMSAM much more tolerable. I personally feel few with anxiety disorters will do well on EMSAM alone.
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> Just like pill form medicines, the patch will can be tweeked by taking it at higher/lower doses (cutting it is the only optioin) as well as taking it on and off, just like many do with the timing of taking their other meds in pill form. Certainly some will be just fine with a 20,30 or 40mg patch 24/7.
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> So other than occation red marks from the patch (which I've come to learn usually results from putting the patch back on a spot I've used within a week) I have mostly benefits, an overall feeling of well being. 10mgs is just enough for me to lift my mood from where it was before, but I doubt that dose would work for anyone with major depression.
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> I don't deal with any issues from food, I eat anything I want. I have lost about 5 pounds over the last few months most likely do to increased physical activity. My sex drive is as good as it has ever been and I certainly don't mind paying half the price by cutting the patch in half as insurance doesn't cover it.
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> For now, it's the best option for me to blend with klonopin. Down the road no doubt there will be more options to consider. Klonopin is my #1 medicine and EMSAM is my "cup of coffee." I am back to being busy living life, being productive and less focused on my disorters. A strange feeling for me, but I'm getting used to it.
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> So I wanted to come back and re-vist all you nice people here at babble and update you on my progress. My hope is that each and every one of you find your answers. I don't think there are any magic bullet out there, but there is always hope that you can get better with the right med or combo of meds.
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> Don't lose hope and remember that because a med works or fails for one particular indivuidual, everyone is different and use the wonderful insight you get from others here at babble as a source of info to discuss with your doctor, hopefully a doctor with exerience in these lousy disorters, one that will think outside the box.
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> Thanks very much to all of you who have helped me by sharing your insight over the last year or so. I can't tell you how much help and insight I have gained here that I will take with me. Good luck to everyone....
>
> RobHi Rob,
I have recently started EMSAM 6mgs., been on it for 15 days today and so far i like it. I also have soc. anx. disorder, GAD, and depression probs. I would really like to stay on the low 6 mg. patch if possible and so far it has relieved my depression. My pdoc as just recently (per my request) switched me from Ativan 6 mgs daily to Klonopin 2 mgs daily. Is 2 mgs a day enough to help with moderate social anxiety? How much Klonopin do you take daily (if you don't mind sharing)? My pdoc says .50 Klonopin is approx equivilent to 2 mgs of ativan...is this correct in your opinion? I just want to make sure that 2 mgs. of Klonopin is an effecient amount to improve SAD symptoms. Your answers to these questions is very much appreciated. Thank you.
Monte
poster:Crazy Horse
thread:663290
URL: http://www.dr-bob.org/babble/20060701/msgs/663338.html