Posted by dewdropinn on July 27, 2007, at 7:31:19
In reply to Re: Patch decision - What to do?, posted by JohnSky on July 26, 2007, at 16:59:03
As for removing the patch at bedtime. I do not believe that the patch delivers medication in a consistent pattern throughout the 24 hour day -- I suspect it releases the majority of the drug during the hours immediately following application, and the amount gradually diminishes throughout the day. While the 4.5mg calculation makes sense if you do straight arithmatic of the dose and hours taken, I pretty sure you're actually getting more than 4.5mg. Also, the efficacy of the drug is closely linked to sleep -- and I think you'll notice this trend with almost everyone who takes MAOIs -- the drug works far better when insomnia is under control. I would experiment with removing the patch because the sleep issue is at least as important as the dosage total.Here's my experience in a tiny nutshell --
1) Lithium and seroquel were just way to powerful -- they severely compromised cognition. Lamictal and klonopin were a much kinder and gentler solution to my low grade bipolar symptoms.
2) The true antidepressant benefits of EMSAM only kicked in at 9mg -- it vastly improved mood, and reduced anxiety.
3) In order for EMSAM to be effective at any dose, I need to sleep. In order to sleep, I need to remove the patch before bed.
Anectodal evidence, rather than scientifically verifiable and universally applicable -- so it may not hold true for you, but it's worked for me.
Drew
> Thanks for your reply aegle. i am not sure about my bi-polar diagnosis with one manic episode in my entire life caused by a medication.
> My doc said they think I am bi-polar because when I stopped taking the medication I continued to be manic for several weeks. I think the mania just runs its course no matter how started (bi-polar... or via a medicine).
>
> I plan to take the 6mg daily (including at night) until Sunday. If my anxiety doesn't back down I want to go to 9mg to give it a try to see if my anxiety drops off as others have experienced when they went to 9mg... and a decrease in depression. I just don't know whether to take the patch off at night. If I don't I think I would only get about 6mg in my blood stream daily???? Ideas and experience?? but I'm not sure wwh
>
poster:dewdropinn
thread:769334
URL: http://www.dr-bob.org/babble/20070719/msgs/772297.html