Posted by em_kath on January 19, 2010, at 10:52:49
In reply to Need advice - Parnate, Emsam, Dexedrine?, posted by evenintherain on January 12, 2010, at 16:57:29
I am in a similar situation where I'm considering Parnate and it is a difficult decision with the risks. I am leaning towards switching to it because, like you, I am starting to think of it as one of the few options left (I have tried many, many different medications with little to no success), and I have heard that it's pulled people out of deep depression after nothing else worked. I have been on Emsam for 6 or 7 weeks and I have not had success on the lowest 6mg dose or the dose that I am on now, the 9mg. But the transdermal delivery largely makes the diet a nonissue. I know to be on the safe side you are supposed to follow the diet on the higher doses, and while I started out following the diet on 9mg, I have gradually been eating more 'forbidden' foods and I am currently not following the diet very strictly at all (though I have been too scared to try aged cheese, I eat most cheeses without worry). I have heard from others that the dietary restrictions are only a precaution on Emsam and that there have been no reports of hypertensive crisis. However I am not on the higher 12mg dose, so I can't say if it becomes an issue then. One of the few positive things I have noticed on Emsam is that I sleep very well. Also, there don't seem to be any sexual side effects (FYI I am female). The only real side effect I have experienced (aside from a reduced tolerance to alcohol) is orthostatic hypotension, where if I stand up too quickly I lose vision for a few seconds and get lightheaded, and yesterday morning I lost my vision for a few minutes before it returned (and fainted for a moment). But this is not unique to Emsam, it can be a side effect with all MAOIs.
So my experience with Emsam has not been satisfactory, and I have decided to switch. Whether I switch to Parnate or something else will depend on the recommendations of my psychiatrist. I have not heard many positive things about Emsam, though I suppose it must be helping somebody or it wouldn't be on the market. I am not convinced that it is strong enough for severe depression, which I have, and you seem to have. If I could go back, I would not bother with Emsam, but of course you might react differently to it than I did, and since you are so concerned about the diet it might be worth a try. If it doesn't work, you could always upgrade to Parnate, but I think that requires another washout period that I am personally not looking forward to. It's always a tough decision with MAOIs. I hope things work out for you and you find something that helps!
poster:em_kath
thread:933399
URL: http://www.dr-bob.org/babble/20100113/msgs/934350.html