Posted by jackford on June 24, 2010, at 1:43:13
In reply to Re: Emsam: Did everyone give up on it?, posted by Matryoshka on June 18, 2010, at 13:37:00
Yes, it is very much like rebuilding after a disaster. Getting through the storm is very tough, can take years. Then the hard work of reconstruction begins . . . can be very daunting
> > There are very few posts about Emsam. I have started the 6mg patch. I noticed agitation, loss of libido and E.D. only slight mood and motivation and mood improvement.
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> Loss of libido at 6mg is unusual, as it primarily boosts dopamine. (Agitation on Emsam makes me suspect you may want to try something that is a bit less activating than Wellbutrin. But then, a higher dose of Emsam may have an anxiolytic effect once you reach MAO-A inhibition and get some serotonin boost.)
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> I've been on Emsam since September of last year. I am not going off it anytime soon. It didn't have significant AD effect until I reached 12mg. I'm also on thyroid hormone (T3) for a mild thyroid impairment, and Adderall (at a very low dose) for cognition and attention.
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> So far it has worked well for me, but I can imagine the combination might be agitating for some people. Anergic depression has been my primary issue, not anxiety.
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> I suspect many people get on the 6mg patch, stay there, and expect to feel better. That's not the way it works. You may easily need 9mg or 12mg to get significant MAO-A inhibition, which is required for antidepressant effectiveness. My advice to anyone on Emsam is that if they can tolerate the skin patch, move up from 6mg to 9mg within 2-3 weeks, and if any glimmer of improvement is felt, move up to 12mg within another 2-4 weeks.
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> Emsam seems to take a while to work compared to even the SSRIs, for some people; for others it works faster than the SSRIs. (A moot comparison for me, as the SSRIs no longer work at all.)
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> I had low dose (75-150mg) Provigil as an augmentation initially (until I developed severe heartburn on it), which was a good booster for energy and mood.
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> If you take sedatives at night, they can be "amplified" by an MAOI and sabotage your energy the next day. Be wary.
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> My mood now feels better than it has in years, although I have to pick up the pieces of a career and social life that was shredded by depression -- but that's the way it goes, isn't it? It's like rebuilding after a disaster.
poster:jackford
thread:950865
URL: http://www.dr-bob.org/babble/20100615/msgs/952046.html