![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 70. Go back in thread:
Posted by SLS on September 16, 2006, at 8:35:00
In reply to discontonuimg Emsam, posted by Donna Louise on September 16, 2006, at 5:40:39
Hmm.
I'm sorry things didn't work out.
Can you express how you experienced the hypomania?
You may have been experiencing a mixed state. Lamictal might not arrest the hypomanic part, but it should help with the depressive part. If you remove the Emsam, retaining the Lamictal might help take the edge off the depression, even though it might not bring you to full remission. If adding the Lamictal and raising the Emsam leaves you in an unacceptably hypomanic state without mixed depressive features, you can either choose to go with Depakote or an atypical AP like Abilify or Zyprexa.
Given your partial response to Emsam, I would proceed to another MAOI should you choose to make a change. If you enjoyed the stimulant-like effects early in your Emsam trial, perhaps you might like Parnate. It doesn't always work like that, though. You know that Nardil and Zyprexa can produce weight gain. However, I think that is probably a better combination for AD effect were one to keep statistics. Parnate + Abilify + Lamictal could work very well, and you shouldn't gain very much weight at all. If you should opt to use Depakote instead of an AP to prevent mania, you must reduce the dosage of Lamictal by 1/2.
Good luck.
- Scott
Posted by Phillipa on September 16, 2006, at 11:16:57
In reply to Re: discontonuimg Emsam » Donna Louise, posted by SLS on September 16, 2006, at 8:35:00
Donna I'm so sorry. I thought you were doing so well on the EMSAM. It saddens me to see this happen to you. Love Phillipa
Posted by Donna Louise on September 16, 2006, at 15:01:24
In reply to Re: discontonuimg Emsam » Donna Louise, posted by SLS on September 16, 2006, at 8:35:00
> Hmm.
>
> I'm sorry things didn't work out.
>
> Can you express how you experienced the hypomania?
>
> You may have been experiencing a mixed state. Lamictal might not arrest the hypomanic part, but it should help with the depressive part. If you remove the Emsam, retaining the Lamictal might help take the edge off the depression, even though it might not bring you to full remission. If adding the Lamictal and raising the Emsam leaves you in an unacceptably hypomanic state without mixed depressive features, you can either choose to go with Depakote or an atypical AP like Abilify or Zyprexa.
>
> Given your partial response to Emsam, I would proceed to another MAOI should you choose to make a change. If you enjoyed the stimulant-like effects early in your Emsam trial, perhaps you might like Parnate. It doesn't always work like that, though. You know that Nardil and Zyprexa can produce weight gain. However, I think that is probably a better combination for AD effect were one to keep statistics. Parnate + Abilify + Lamictal could work very well, and you shouldn't gain very much weight at all. If you should opt to use Depakote instead of an AP to prevent mania, you must reduce the dosage of Lamictal by 1/2.
>
> Good luck.
>
>
> - Scottthanks for responding Scott, I am really in a bad place.
the hypomania is definately a mixed state type, very agitated, OCD like, rageful, that sort of thing. the lamictal helped with that but now i am so depressed i can barely stop crying. sleeping is the only way to get away from it. i can't even get my shoes on and go for a walk. never have i felt so depressed while on an AD. I didn't know if the lamictal was making it worse, even though it is supposed to help with anxiety and depression, both i have in buckets full. I had suspected i had the soft bipolar kind and the patch brought it out. i don't know if any maoi would not do that. i did like the energy since the usual ad's make me sleepy and unmotivated. i was thinking i would go back to effexor and add a few mg of selegiline, keep the lamictal. pdoc back on tues, wait until she hears what i have done. pulled the plug on 12mg patch, go cold turkey and get it over with like i did with effexor and paxil. blah blah, i am sick of listening to myself.
Posted by jaclinhyde on September 16, 2006, at 16:09:45
In reply to Re: discontonuimg Emsam » SLS, posted by Donna Louise on September 16, 2006, at 15:01:24
I am bipolar (also mild) and am on Emsam (18mg/2 9mg patches daily) with no affect on that afflication. I know I am lucky and I am sorry that it has brought out the bad side for you. Parnate is the MAOI of choice for people who are bipolar with less of a tendency to jump into a manic state. YOu might give it a try. No weight gain either...in fact weight loss is the norm.
Terri
Posted by Donna Louise on September 16, 2006, at 17:16:14
In reply to Re: discontonuimg Emsam, posted by jaclinhyde on September 16, 2006, at 16:09:45
> I am bipolar (also mild) and am on Emsam (18mg/2 9mg patches daily) with no affect on that afflication. I know I am lucky and I am sorry that it has brought out the bad side for you. Parnate is the MAOI of choice for people who are bipolar with less of a tendency to jump into a manic state. YOu might give it a try. No weight gain either...in fact weight loss is the norm.
>
> Territhat is important, no weight gain. and not a tendency to get that awful mixed state. I was afraid it would make me too jumpy from what i have read, seems that is a problem for me but sounds like the votes are coming in for parnate. what have i got to lose? I am making an emergency appt to see the pdoc as soon as she gets in tues and will talk to her about that.
thanks for responding, that helps as much as anything, people are listening and care enough to answer. that really really helps.donna
Posted by willyee on September 16, 2006, at 23:29:54
In reply to Re: discontonuimg Emsam » jaclinhyde, posted by Donna Louise on September 16, 2006, at 17:16:14
> > I am bipolar (also mild) and am on Emsam (18mg/2 9mg patches daily) with no affect on that afflication. I know I am lucky and I am sorry that it has brought out the bad side for you. Parnate is the MAOI of choice for people who are bipolar with less of a tendency to jump into a manic state. YOu might give it a try. No weight gain either...in fact weight loss is the norm.
> >
> > Terri
>
> that is important, no weight gain. and not a tendency to get that awful mixed state. I was afraid it would make me too jumpy from what i have read, seems that is a problem for me but sounds like the votes are coming in for parnate. what have i got to lose? I am making an emergency appt to see the pdoc as soon as she gets in tues and will talk to her about that.
> thanks for responding, that helps as much as anything, people are listening and care enough to answer. that really really helps.
>
> donnaOne good thing about parnate is its fast,as far as its initial come on.Nomraly you wont have to wait very long for some form of relief if its gonna work for you,its known to be one of the most fast acting anti depressants.You sound in a terrable state,and even if in the long run you opt to change parnate,it sounds like a good choice for you again due to the fact that its a fast acting drug,and you definatly can use a drug that will take effect asap.
Also i wouls ask,even thought you have depression,and klonopin can be hard on it,still i consider it a life saver when things are so bad to where you described you cant go for a walk.
If youre not already,id look into slowly creeping up onto a steady dose if klonopin,your depression might worsen at first,but in the long run your anxiety levels will decrease dramaticaly and more likly so will your hypomania.I find no other benzo capable of producing the reliaf klonopin does,nor any other drug period,lamictal and the like,they all have value,but klonopin to me holds a life saving value,if your on it id consider looking into getting it raised temporaly,especialy with deprenyl i know personaly klonopin has a synergy with this drug both in raising it,and lowering it,it seems to,and a weird term here,ride with the drug.
So id recomend Klonopin and parnate later on to get u to a safer state,just my two cents from dealing with the med in question,as i have also exper the mania deprenyl is capable of,and it can make u feel like ur mad,its quite scary,i couldent even sit beside people,thats how bad it got,my state now is nothing like that,nor was it ever except on it.
Posted by Donna Louise on September 17, 2006, at 5:40:51
In reply to Re: discontonuimg Emsam, posted by willyee on September 16, 2006, at 23:29:54
> > > I am bipolar (also mild) and am on Emsam (18mg/2 9mg patches daily) with no affect on that afflication. I know I am lucky and I am sorry that it has brought out the bad side for you. Parnate is the MAOI of choice for people who are bipolar with less of a tendency to jump into a manic state. YOu might give it a try. No weight gain either...in fact weight loss is the norm.
> > >
> > > Terri
> >
> > that is important, no weight gain. and not a tendency to get that awful mixed state. I was afraid it would make me too jumpy from what i have read, seems that is a problem for me but sounds like the votes are coming in for parnate. what have i got to lose? I am making an emergency appt to see the pdoc as soon as she gets in tues and will talk to her about that.
> > thanks for responding, that helps as much as anything, people are listening and care enough to answer. that really really helps.
> >
> > donna
>
> One good thing about parnate is its fast,as far as its initial come on.Nomraly you wont have to wait very long for some form of relief if its gonna work for you,its known to be one of the most fast acting anti depressants.You sound in a terrable state,and even if in the long run you opt to change parnate,it sounds like a good choice for you again due to the fact that its a fast acting drug,and you definatly can use a drug that will take effect asap.
>
> Also i wouls ask,even thought you have depression,and klonopin can be hard on it,still i consider it a life saver when things are so bad to where you described you cant go for a walk.
>
>
> If youre not already,id look into slowly creeping up onto a steady dose if klonopin,your depression might worsen at first,but in the long run your anxiety levels will decrease dramaticaly and more likly so will your hypomania.
>
> I find no other benzo capable of producing the reliaf klonopin does,nor any other drug period,lamictal and the like,they all have value,but klonopin to me holds a life saving value,if your on it id consider looking into getting it raised temporaly,especialy with deprenyl i know personaly klonopin has a synergy with this drug both in raising it,and lowering it,it seems to,and a weird term here,ride with the drug.
>
> So id recomend Klonopin and parnate later on to get u to a safer state,just my two cents from dealing with the med in question,as i have also exper the mania deprenyl is capable of,and it can make u feel like ur mad,its quite scary,i couldent even sit beside people,thats how bad it got,my state now is nothing like that,nor was it ever except on it.I have been "moody" all my life but not to the extent that I have been on the patch, and that is with klonopin. I know i couldnt have taken the patch at all without it. I agree with you, it makes a big difference with me regardless of whatever i am trying.
I was afraid that the patch and parnate would be almost identical in terms of stimulation and feared that it would really be no different than the patch. But you are saying you have taken both and they are totally different in their effects on your mood. That info suprises and really helps make unafraid to give it a try. My ride season is approaching (horses, distance riding) and at this rate i won't be able to go so you are right, I need something fast acting for that reason too, not to mention it would be nice to take a walk.
I feel better than I did yesterday but could be crying again by this afternoon. I decided to cut the patch in half and take 6mg so hopefully i can see a friend as planned for a long time this weekend and not be in a bad withdrawal.
thanks so much for replying, Willyee.
Posted by willyee on September 17, 2006, at 17:32:07
In reply to Re: discontonuimg Emsam » willyee, posted by Donna Louise on September 17, 2006, at 5:40:51
> > > > I am bipolar (also mild) and am on Emsam (18mg/2 9mg patches daily) with no affect on that afflication. I know I am lucky and I am sorry that it has brought out the bad side for you. Parnate is the MAOI of choice for people who are bipolar with less of a tendency to jump into a manic state. YOu might give it a try. No weight gain either...in fact weight loss is the norm.
> > > >
> > > > Terri
> > >
> > > that is important, no weight gain. and not a tendency to get that awful mixed state. I was afraid it would make me too jumpy from what i have read, seems that is a problem for me but sounds like the votes are coming in for parnate. what have i got to lose? I am making an emergency appt to see the pdoc as soon as she gets in tues and will talk to her about that.
> > > thanks for responding, that helps as much as anything, people are listening and care enough to answer. that really really helps.
> > >
> > > donna
> >
> > One good thing about parnate is its fast,as far as its initial come on.Nomraly you wont have to wait very long for some form of relief if its gonna work for you,its known to be one of the most fast acting anti depressants.You sound in a terrable state,and even if in the long run you opt to change parnate,it sounds like a good choice for you again due to the fact that its a fast acting drug,and you definatly can use a drug that will take effect asap.
> >
> > Also i wouls ask,even thought you have depression,and klonopin can be hard on it,still i consider it a life saver when things are so bad to where you described you cant go for a walk.
> >
> >
> > If youre not already,id look into slowly creeping up onto a steady dose if klonopin,your depression might worsen at first,but in the long run your anxiety levels will decrease dramaticaly and more likly so will your hypomania.
> >
> > I find no other benzo capable of producing the reliaf klonopin does,nor any other drug period,lamictal and the like,they all have value,but klonopin to me holds a life saving value,if your on it id consider looking into getting it raised temporaly,especialy with deprenyl i know personaly klonopin has a synergy with this drug both in raising it,and lowering it,it seems to,and a weird term here,ride with the drug.
> >
> > So id recomend Klonopin and parnate later on to get u to a safer state,just my two cents from dealing with the med in question,as i have also exper the mania deprenyl is capable of,and it can make u feel like ur mad,its quite scary,i couldent even sit beside people,thats how bad it got,my state now is nothing like that,nor was it ever except on it.
>
> I have been "moody" all my life but not to the extent that I have been on the patch, and that is with klonopin. I know i couldnt have taken the patch at all without it. I agree with you, it makes a big difference with me regardless of whatever i am trying.
> I was afraid that the patch and parnate would be almost identical in terms of stimulation and feared that it would really be no different than the patch. But you are saying you have taken both and they are totally different in their effects on your mood. That info suprises and really helps make unafraid to give it a try. My ride season is approaching (horses, distance riding) and at this rate i won't be able to go so you are right, I need something fast acting for that reason too, not to mention it would be nice to take a walk.
> I feel better than I did yesterday but could be crying again by this afternoon. I decided to cut the patch in half and take 6mg so hopefully i can see a friend as planned for a long time this weekend and not be in a bad withdrawal.
> thanks so much for replying, Willyee.
>Yess there is a initial reseambalance,but personaly having used both extenivsly i would say the two drugs are different,deprenyl regardless of dose when accumlated creates a ora of agigtation,anxiety,depression,and hypomania.
Parnate for whatever reason doesent seem to feel as if it accumaltes so,this has its downside for parnate in the long run for some becomes to sedating,im having trouble because of fatigue and lack of stumulation the drug is providing,but ve been on it 5 years,but im in need of a very long vaction from it,but remebering its effect the first year on it,i would definataly recomend it as an option to one in need of a effective possable anti depressant.
Even when i heard deprenyl was comming out in patch,and the dose factor,i still was surprised as i always contained,this through reading groups that really use this drug in small doses,that this is what its mainly for,the oral form is most potent and best used very sparingly in mg drops to aid in conjunction with other drugs,or to serve for minor depression being used sparingly on a couple of days cycle.To have deprenyl being pumped into the blood stream at any dose just dident sound assuring to me,which is why i actualy turned the patch down,which i never would do on a possable alternative,i was offered it on its first week,and knowing it as i do,opted to wait because i just had trouble seeing it NOT causing mania.Good luck
Posted by Phillipa on September 17, 2006, at 19:27:08
In reply to Re: discontonuimg Emsam, posted by willyee on September 17, 2006, at 17:32:07
Donna does Robert know? So you're bipolar maybe that's the differance, As far as I know he is still doing well on it. Love Phillipa
Posted by jealibeanz on September 17, 2006, at 21:03:18
In reply to Re: discontonuimg Emsam, posted by willyee on September 17, 2006, at 17:32:07
You think denepryl is really not great for chronic use? Do you have any info/articles about this?
Posted by Donna Louise on September 17, 2006, at 22:06:11
In reply to Re: discontonuimg Emsam, posted by willyee on September 17, 2006, at 17:32:07
today is the second day I have reduced the patch to 6mg. And I feel much better today. of course that could all change by tomorrow but I am wondering if this is a case where less is more. The only reason I ever went up all the way to 12mg was thinking that it would give more serotonin and therefore less anxiety and agitation. I wonder now if I had just stayed on 6mg and added the lamictal at that time and higher dose of klonopin like i am on now (still only 1mg divided during the day, not very much..) if I would have been ok. Maybe I will be ok now. oh, that is too much to be hopeful for..I have actually gotten my shoes on for the past two nights and taken one of the dogs for a walk. Even jogged about 1/3 of the route tonight. If I could steady out here...or this could just be another grand swing. I will let you know.
Posted by Phillipa on September 17, 2006, at 22:27:13
In reply to Re: discontonuimg Emsam, posted by Donna Louise on September 17, 2006, at 22:06:11
Please let me know as I was going to try it and now I'm crying cause I feel out of options and the thread I started last night didn't help. Love Phillipa
Posted by JOP on September 18, 2006, at 0:56:16
In reply to Re: discontonuimg Emsam » Donna Louise, posted by Phillipa on September 17, 2006, at 22:27:13
> Please let me know as I was going to try it and now I'm crying cause I feel out of options and the thread I started last night didn't help. Love Phillipa
Phillipa—
I have been lurking on this board for quite some time and noticed that you are one of the first people to jump in and offer support to others who are dealing with emotional turmoil. However, it seems that you too are struggling with your own emotional turmoil and I would like to be here to support you in any way I can.
I can relate to your hesitation related to trying EMSAM. I too was hesitant and skeptical, as any antidepressant I have tried in the past has done zilch to raise my mood. While you seem to be very sensitive to medications and their side effects, I have the exact opposite problem. Of the 20+ “psychoactive” drugs I have tried over the past 17 years, I received no positive benefits and the only negative side effects were the pesky dry mouth on TCAs, 50 pounds of extra weight from Zyprexa, and some slight itching on EMSAM (so I guess they must be doing “something”—and yes I do realize I am EXTREMELY lucky not to have ventured into side effects hell like so many others on this board).
While I am thinking of increasing the dose of EMSAM, I am also thinking of throwing in the towel on this one and jumping to Parnate since I will have to follow the MAOI diet on a higher dose of EMSAM.
What I am getting at is that I have realized that this mood disorder that I have (chronic treatment resistant mdd) is something that is slowly draining the life out of me and frankly, that pisses me off. Yes, I am angry. I will not let this thing become some sort of terminal illness that I carry around with me for the next odd number of years suffering needlessly waiting for the day it kills me. We all deserve so much more.
So here is my point. Try EMSAM. You can read all of the experiences of others on this board, but those experiences will never be yours. If you are sensitive to medications, cut the patch in half. Cut the patch in quarters. Cut the patch in eights. Go low and slow and see how you react to it. If you start experiencing negative side effects that you can’t tolerate (i.e. increased anxiety) take it off, throw it away and move on to something else.
You will ALWAYS have the support of this board to help in any way we can. Yes, it is scary, but what if this drug helps your mood even slightly? What if it’s a true magic bullet at the lowest dose and gives you excellent relief? You won’t know until you try and if your pdoc is supportive, so is everyone else here.
Unfortunately, pharmacogenomics is not advanced enough at this point to help us out and point us to the right drug at the right dose so all we have right now is the experience of our pdocs and trial and error.
PLEASE don’t give up. We’ll all fight this together until we can wake up happy, go through our day experiencing a full range of healthy emotions, and go to bed and sleep soundly.
We’re all with you.
JOP
Posted by Donna Louise on September 18, 2006, at 5:28:49
In reply to Re: discontonuimg Emsam » Phillipa, posted by JOP on September 18, 2006, at 0:56:16
Posted by Phillipa on September 18, 2006, at 19:43:21
In reply to Re: discontonuimg Emsam » Phillipa, posted by JOP on September 18, 2006, at 0:56:16
Jop not to take away from anyone else I feel much better thinking you think so highly of me that you would post to me as a lurker. You must be a wonderful person. I'd love to know you if you like you can babblemail me and I'll give you my e-mail. As soon as I get over the diverticulitis I will again wean off the luvox and hopefully work up the courage to try the boxes I already have. Love Phillipa that meant so much to me
Posted by willyee on September 18, 2006, at 20:13:06
In reply to Re: discontonuimg Emsam, posted by jealibeanz on September 17, 2006, at 21:03:18
> You think denepryl is really not great for chronic use? Do you have any info/articles about this?
No the opposite actualy,i foolow a group called smart drugs and nutrients,which speaks on the use of both drugs and nutrients and importance of both.
In the book titled actualy so,part two,there is an entire chapter on deprenyls use for depression,there it speaks on the low dosage used for depression.
Also following the group it was just a drug known to be used sparingly since it had such a imapct on dopamine specifcaly.
I can only speak from my own usage,and my worry was the more specific direct impact on dopamine as opposed to all the chemicals that dopamine seemed to work on.
Deprenyl was a parkinson disease drug,as well as recomended for smoking cessation because of its impact on dopamine,i have heard the dose increase would change that more however it still concerned me,having it used it myself i could feel the dopamine accumaltion and the side effects that would occur.
I dont discourage anyone from it though,its new,novel,fairly safe,in fact i told a specific person im not sure why they are waiting so long to try it,everyone is different and the only sure thing is to try it urself.I having used it was just offering advice on tapering down since i had to do so myself.
I hardly ever discourage anyone from seeking help,seeking alone shows you are willing to keep trying.
Posted by Donna Louise on September 18, 2006, at 20:28:15
In reply to Re: discontonuimg Emsam, posted by willyee on September 18, 2006, at 20:13:06
> > You think denepryl is really not great for chronic use? Do you have any info/articles about this?
>
> No the opposite actualy,i foolow a group called smart drugs and nutrients,which speaks on the use of both drugs and nutrients and importance of both.
>
> In the book titled actualy so,part two,there is an entire chapter on deprenyls use for depression,there it speaks on the low dosage used for depression.
>
> Also following the group it was just a drug known to be used sparingly since it had such a imapct on dopamine specifcaly.
>
> I can only speak from my own usage,and my worry was the more specific direct impact on dopamine as opposed to all the chemicals that dopamine seemed to work on.
>
>
> Deprenyl was a parkinson disease drug,as well as recomended for smoking cessation because of its impact on dopamine,i have heard the dose increase would change that more however it still concerned me,having it used it myself i could feel the dopamine accumaltion and the side effects that would occur.
>
>
> I dont discourage anyone from it though,its new,novel,fairly safe,in fact i told a specific person im not sure why they are waiting so long to try it,everyone is different and the only sure thing is to try it urself.
>
> I having used it was just offering advice on tapering down since i had to do so myself.
>
> I hardly ever discourage anyone from seeking help,seeking alone shows you are willing to keep trying.
>
>The big appeal to me that the patch offered was bypassing first pass metabolism so much more of the parent compound was available and much less of the amphetamine metabolites than with oral route. Theoretically, these patches are non selective and should deanimate serotonin and norepinephrine as well as dopamine, as only dopamine is deanimated with the oral selegiline at the low mg. So I am suprised to find it still so activating,. I am liking and needing the activation, that isn't the problem, is just does not seem to working as an AD for me and has made all these soft bipolar nightmares very apparant. But that is just me. I had a good day today except for the meltdown in the middle of the day. Cycling? just insufficiently treated? All I know is if it works like I would think it should, it would be an awesome drug. so like Willyee says, try it, it could be the best thing you have had yet.
Donna
Posted by jealibeanz on September 18, 2006, at 21:03:03
In reply to Re: discontonuimg Emsam, posted by willyee on September 18, 2006, at 20:13:06
Oh, I think I misunderstood. You're saying it is an effective AD? Just that it's normally at a lower dose?
Posted by Phillipa on September 18, 2006, at 21:09:24
In reply to Re: discontonuimg Emsam » willyee, posted by Donna Louise on September 18, 2006, at 20:28:15
Well if EMSAM is like wellbutrin I can't take it it put me in the hospital my pdoc at the time though I was manic. Love Phillipa
Posted by willyee on September 19, 2006, at 8:06:49
In reply to Re: discontonuimg Emsam » Donna Louise, posted by Phillipa on September 18, 2006, at 21:09:24
> Well if EMSAM is like wellbutrin I can't take it it put me in the hospital my pdoc at the time though I was manic. Love Phillipa
No i dident find it to be like wellbutrin,its a LOT nicer of course in my eyes,if that is a comparison basis then parnate is more like it,however still deprenyl is quite unique,and the best way to tell and the most effective way is to try it,i think you have enough information from what i alone seen you particpate in,are you possably letting your anxiety stop you again,if so maybe you should let your anxiety work for you,and set a date,and say to urself u HAVE TO start the med on this date,trick your thinking if you have to,but in all honesty research and questions will take u so far down the road,and sooner or later you have to get out the car and go inside for yourself,its really the only way unless you decide for sure your not going too.
Other than that,you will continue to swing like a pendalum as even the best considered drugs here are still debated,none i dont believe carry a solid sense of security that it will work or not possably worsen an individual
Posted by SLS on September 19, 2006, at 8:14:22
In reply to Re: discontonuimg Emsam » willyee, posted by Donna Louise on September 18, 2006, at 20:28:15
> Theoretically, these patches are non selective and should deanimate serotonin and norepinephrine as well as dopamine, as only dopamine is deanimated with the oral selegiline at the low mg. So I am suprised to find it still so activating,
Remember, the selegiline molecule itself might be acting as a stimulant. From what I have been able to find on Medline, and have previously posted about, it is.
I am sorry it is not doing the job for you as an antidepressant.
Have you tried any other MAOIs?
- Scott
Posted by Donna Louise on September 19, 2006, at 13:15:43
In reply to Re: discontonuimg Emsam » Donna Louise, posted by SLS on September 19, 2006, at 8:14:22
> > Theoretically, these patches are non selective and should deanimate serotonin and norepinephrine as well as dopamine, as only dopamine is deanimated with the oral selegiline at the low mg. So I am suprised to find it still so activating,
>
> Remember, the selegiline molecule itself might be acting as a stimulant. From what I have been able to find on Medline, and have previously posted about, it is.
>
> I am sorry it is not doing the job for you as an antidepressant.
>
> Have you tried any other MAOIs?
>
>
> - Scottyes, from what i have read, the selegiline molecule is of an activating nature. I really like the activation as everything else i have taken makes me sleep all the time and zero motivation, lots of apathy. I would hate to lose that aspect of this drug. And I do feel better now that I am just taking 6mg as opposed to 12mg. the 150 of lamictal may be getting a chance to help too but I would sure feel better about it if I didn't have that meltdown yesterday. Intense rage then a bunch of sobbing. Then within an hour after taking ,5mg klonopin, felt fine again. I have actually been able to take two walks, one with partially jogging even since i went down to 6mg. I have an emergency appt with the pdoc Thursday and then I will be out of town until Sunday so will be unable to update those of you who are interested (which I am on my knees grateful for).
After all that long windedness (which is what I had originally at 6mg, longwindedness..) to answer your question, no I have not been on other MAOI's. But from what is being suggested and what I am reading, it sounds like Parnate would be a good choice with the klonopin and lamictal. I am such a good sleeper I don't worry about insomnia. Has anyone heard of a bipolor II or any other bipolar type that is a good sleeper all the time?
Thanks Scott,Donna
Posted by jealibeanz on September 19, 2006, at 18:45:07
In reply to Re: discontonuimg Emsam » SLS, posted by Donna Louise on September 19, 2006, at 13:15:43
Donna, are you discontinuing the EMSAM? I have anxiety, as well as depression, and insomnia. Right now I am taking Provigil, 400 mg due to excessive daytime sleepiness. My anxiety increased when I began, so my doctor allowed my to increase my Xanax to 1mg t.i.d. I also take Lunesta. I'd like to ask my doc about giving EMSAM a try, but worry it may increase anxiety. However, I'm thinking that if I drop the Provigil, the Xanax may counter it.
Posted by Phillipa on September 19, 2006, at 20:48:18
In reply to Re: discontonuimg Emsam, posted by jealibeanz on September 19, 2006, at 18:45:07
Jelly you sound like me and you're asking the same questions with the same concerns. Another concern of mine is that when I get to l2.5mg of luvox my crying starts and then back to 25mg which seems to stop it. So how do you go through a two week wash out period without going insane?And is it true that even if you take off the patch the meds are in your body for 9 days? And then another two week wait to try something else? Love Phillipa
Posted by Donna Louise on September 28, 2006, at 5:42:05
In reply to discontonuimg Emsam, posted by Donna Louise on September 16, 2006, at 5:40:39
Well, I took the plunge and pulled the patch. Nice alliteration if I do say so myself...
I am on my 3rd day and so far no withdrawal unless these headaches are part of it. I doubt it, they started when I went up to 200mg lamictal. I am going to see if they don't go away, I have migraine medicine I take. And right now i feel better than I have for the past month. But I know that never lasts...unless this time I can get some mileage out of just the lamictal, klonopin and provigil. but even with the new understanding that i probably have bipolar II, I get such bad depression I can't imagine that I can get away with it and at some point will have to take yet another AD. I keep thinking that if I took a tiny dose of oral selegiline I could keep the energy and lose the mixed state..
Anyway, that is my update.donna
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