Posted by shoshana on December 28, 2006, at 20:50:59
In reply to Re: Emsam Users, length of time, effects,pros/cons, posted by RN320 on December 28, 2006, at 18:24:53
Dear Garden Girl, RN320, and Vicki,
Thank you for your replies. RN320 - I'm sorry to hear that you passed out - I hope that the florinef will be of help with this and that the provigil will help with your cognitive issues.
Re: akathisia - my doctor has never used this term with me and I was not familiar with it but I just looked it up. The sensation that I feel is very physical, so it is possible that it is akathisia that I am experiencing. It feels like my heart is pounding and adrenaline is pumping at a high rate through my veins and will not stop. I have never had any food sensitivities of this type before, so I believe that it must somehow be associated with the Emsam. I'm glad to know that it doesn't sound at all like a tyramine reaction.
As to my muscle twitching, I notice it mostly when I'm lying down. It is pretty mild but I will still keep an eye on it.
The information on the 'sensory hallucinations' is interesting. It's good to know that this is a known issue with some people and interesting to learn that those who experience depression are more sensitive to it. When I first started smelling the foul odor, I went crazy trying to clean everything and sprayed lysol everywhere but to no avail. When I noticed that I was smelling it in various other places, I realized that it must be in my head, rather than in my environment. It's a pretty gross smell (I think I'll continue to think of it as 'spoiled milk' as opposed to 'rotting flesh'!) In any case, I don't experience it all of the time and in the scheme of things, it is bearable.Thanks again for everyone's input. I'm so happy to have discovered such a supportive community here.
Wishing one and all a very happy New Year.
-Shoshana
> > > I am going to make an appointment to see my doctor, though, probably some of the side-effects could be controlled by watching what I eat (even though the patch at this level is not supposed to have dietary restrictions - I have noticed a reaction after I have had some of the things on the 'do not eat' list for those MAOIs of a higher dosage). Side-effects:
> > >
> > > 1) Head-rushes: I have to grab on to the wall/furniture sometimes to prevent myself from falling, when getting up from my bed or from a seated position.
> > > 2) Changes in blood pressure: I have always had very good blood pressure. Recently, when I started getting head-rushes, I checked and noticed that my average blood pressure has dropped around 30 points.
> >
> > These are both due to orthostatic hypotension, which RN320 described well above. Your blood pools in your legs when you are sitting or lying down, and when you get up you get dizzy and lightheaded since there is not enough blood up in your head yet. As RN320 said, getting up slowly and allowing your blood to adjust is the key to dealing with this. In mild cases, the main risk/problem with OH is the risk of falling or passing out and getting injured, so if you hang onto something and go slow, you can avoid problems. It's unpleasant though. In more severe cases, it can be a "deal-breaker" as far as the medication goes.
> >
> > > 3) Acute insomnia: I cannot sleep more than 3 hours a night on my own. If I take Klonopin, Xanex, or Ambien, I get an extra 2 hours, at best.
> >
> > I'm on Nardil not Emsam, so I can't speak to this directly. But with Nardil, the insomnia lessened in time, and I'm usually able to get a full night of sleep with Ambien.
> >
> > > 4) Mild memory problems and problems concentrating: I think this may be caused by lack of sleep, though the symptoms seems to slowly be getting worse.
> >
> > You could be right about the lack of sleep, though it's worth talking to your doctor about.
> >
> > > 5) Hypersensitivity to light in the morning: when I go out of my house in the morning, I feel like the sky is painfully bright and it hurts my eyes.
> >
> > I have no idea about this one, though I experience it at times due to my light-colored eyes. It's awful when it happens.
> >
> > > 6) Detection of a strange odor: I very often feel as if I'm smelling spoiled milk and can't get rid of the smell. It occurs when I'm in different places (at home, at work, at a store, etc), so I know it doesn't have anything to do with my housekeeping skills!
> >
> > Ugh, how awful. If you were only experiencing this at home, I'd say check your ducts. I had a similar experience where I was smelling this foul odor all over the house, and I thought it was me at one point! It was an animal, probably a squirrel or chipmunk who had climbed into the heat ducts and died. Bleah. I hope this goes away soon.
> >
> > > 7) Extreme anxiety: Feels as if I'm having a very severe panic attack (which I'm not): I noticed that this happened the other day after I had one piece of imported chocolate. It can last for several days and is very unpleasant. I have tried to alleviate the feeling of anxiety by working out at the gym and it helps only slightly. Also, Xanex helped a little bit.
> >
> > I'd be surprised if any of the symptoms you describe are related to eating something with tyramine. The main reaction with tyramine is an increase in blood pressure, which usually results in a terrible headache and can lead to a hemorrhagic stroke. Nardil at 75 mg gave me akathisia and severe insomnia (probably related to the akathisia). I couldn't sit still and felt like I was jumping out of my skin. This felt similar to panic, though it was a more physical reaction. Could your experience be more like akathisia?
> >
> > > 8) Difficulty doing simple math equations: For example, I used to be the person everyone turned to when figuring out the bill at a restaurant. Now I have problems calculating in my head and have stopped trying because it is too frustrating. This also may be caused by lack of sleep (?)
> >
> > Again, I think I'd check with your doc, but lack of sleep definitely interferes with cognition.
> >
> > > 9) Involuntary muscle spasms: I had these when I was taking Cymbalta and they seem to have returned but they are less frequent and not as strong.
> >
> > Is this only at certain times? With Nardil I get myoclonic jerks at times--that whole body jerk associated with going to sleep. They get stronger with dosage decreases, actually. But I can get several in a row when I am first trying to get to sleep.
> >
> > I hope your side effects resolve since Emsam is working for you. And hopefully you can find something to target anxiety as well. Good luck!
> >
> > gg
> >
>
>
> Hi Shoshana-
> I agree with Garden Girl's post above. It doesn't sound like you're having a tyramine food reaction (aka "The Cheese Reaction"!) If it were the tyramine you'd have the opposite reaction. Your reactions to these foods is really interesting and if you never had them before the EMSAM, it's seems like it would be connected in some way. Sorry, but I have nothing scientific to offer as a possible explanation for this one.
>
> About your orthostatic hypotension- I can really relate. I thought that mine was pretty well controlled by changing the way that I do things (related to sitting, laying, rising and bending) but just last Friday I passed out when standing up from exercising on a recumbent stepper in cardiac rehab....I thought that I had sat up for long enough and was stabilized because I felt ok, so I got up .....and dropped like a rock. So they kind of kicked me out of rehab until my docs can figure out what they're going to do (internist and pdoc). I see them both tomorrow. Right now, they're considering 2 things for me- a drug called florinef which is used to raise blood pressure for people on drugs that create this very situation.
>
> The other drug that is being considered in addition to florinef is provigil because I too am having cognitive difficulties (mine aren't attributed to the EMSAM, but to a new drug recently added for sleep- not really new, but new to me- trazadone. Trazadone can cause cognitive problems. (I had bad insomnia before emsam, and I don't think it's made it any worse- well maybe a little at the beginning- but I've always been on something for sleep since the onset of the depression. I got changed over to trazadone once the seroquel stopped working for me.) I am just starting to get caught up on some of the sleep I've needed since 6 weeks ago, and my pdoc is thinking that the sleep deprivation may well be adding to the cognitive problems.
>
> Even though I hate the idea of adding any more drugs to my already long list, I will give any of this a try so that I can stay on the EMSAM since it's done so much for me.
>
> You mention the anxiety factor.....I was very high anxiety when I started on EMSAM. In the early days at the 6mg dose I did experience an increase in anxiety. It is pretty much gone and even much reduced from pre-EMSAM days now that I'm at the 12mg dose. GG made a really good point about checking to see if your neuro spasms and what you're calling anxiety may be realted more to akasthisia. I think that's worth looking into.
>
> About the "odor" that you're sensing... My understanding is that this can be from several different things. I had this briefly several years ago (way before EMSAM) and was told by both my pdoc and therapist that it's almost the same as the "aura" that people with epilepsy get prior to a seizure and they said that it has nothing to do with epilepsy, it's just stimulation to your brain that's similar. It is also sometimes referred to as a "sensory hallucination". It's been described as the odor of rotting flesh, rotting eggs and other really gross things! Mine went away all by itself. They still have no precise answer for me that spells out exactly why this happened, just that they have seen it in others who have atypical depression. I was told however, that it could be from lack of sleep, (as I've mentioned above it's a big problem for me when the meds quit working) since sleep deprivation can cause hallucinosis in anyone, but apparently us depressed folks are more sensitive to this type of hallucinosis. Anyway, that's what they told me.
>
> I also have increased sensitivity to light. My eyes have always been somewhat sensitive because I have blue eyes, and that's common for "light colored eyes". It's not unbearable for me, but it's definitely increased since I've been on EMSAM.
>
> I had some myoclonic jerking at bedtime myself a few months ago. It was happening frequenlty- sometimes twice a night and I was even biting my tongue sometimes. It's been gone now almost entirely for probably 2 months. (I went up to 12 mgs EMSAM in September, I think). It's really unpleasant, and klonopin only worked for me in huge doses (like 15-20mg) and I wanted no part of that. Be sure to watch for some any signs of TD.
>
> My heart is with you on this one. I know how nice it is to find something that really helps you feel better. The qualtiy of my life has been so improved by EMSAM that I'd do just about anything to stay on it. I sincerely hope that you're able to work around these difficulties and continue to feel better. Happy New year, Shoshana
> /m
>
poster:shoshana
thread:703921
URL: http://www.dr-bob.org/babble/20061224/msgs/717122.html