Posted by aegle on July 14, 2007, at 8:52:35
In reply to Re: EMSAM Question Again - Help, posted by JohnSky on July 13, 2007, at 15:58:22
John, my experience with Emsam has been very similar to yours. I started taking it in March of this year.
At 6mg, my anxiety level increased dramatically and felt little active relief from depression. The most obvious symptom that the medication was working was a reduction in thoughts of self-harm by about 90%.
I managed the anxiety by using benzos (Xanax, in my case), along with the other methods of self-care - aerobic exercise, eliminating caffeine from my diet, using relaxation exercises - and those helped me get through.
My psychiatrist was hesitant to increase my dosage given the foregoing, but a family health crisis precipitated a severe mood dip, so after eight weeks on 6mg, we increased my dose to the 9mg patch. The relief is palpable. Instead of increasing, my anxiety level dropped to a lower level and my symptoms of depression have lifted more than I could have thought possible.
I've gotten a tremendous boost in energy and motivation, and as an atypical depressive, these effects are very welcome. As I'm able to be more active, my mood is far brighter. I feel more optimistic today than I have in 14 years after medication trials with every other SSRI, SNRI and augmenting strategy (mood stabilizers, atypical antipsycholitcs, stimulants). I'm considering returning to work full-time after a long absence.
For me, Emsam is a miracle drug, but it can't fix everything. I often feel "tired but wired" in mid-afternoon, but that passes. I need to take a small dose of Seroquel (12.5mg) with Xanax in order to fall asleep. And, I'm still dealing with some anxiety and a fairly high level of irritability. However, the latter have been aspects of my personality for as long as I can remember and can not be attributed to this medication. I'd adore it if all those issues could be relieved with medications, but (again) after numerous med trials and 11 years on Effexor, I know now that will be my work.
I strongly urge you to consider staying with the medication. If your experience continues to mirror that of the other participants here, an increase to 9mg could provide the relief you've been seeking. The fact that you're experiencing an uptick in anxiety, while extremely uncomfortable, is also a promising sign - it means you'll most likely be an MAOI responder.
With regard to cutting the patch, I read in the babble archives of a patient (Robert David) who contacted one of the researchers on the Emsam trials and was told it was acceptable to cut the patch. Here's a link to that post:
http://www.dr-bob.org/babble/20060520/msgs/646774.html
Wishing you relief soon.
poster:aegle
thread:769334
URL: http://www.dr-bob.org/babble/20070710/msgs/769520.html