Posted by Donna Louise on July 2, 2006, at 6:03:10
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...
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> 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).
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> #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.
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> 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.
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> Thanks again.
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> 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
poster:Donna Louise
thread:660319
URL: http://www.dr-bob.org/babble/20060701/msgs/663472.html