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Dr. Bob is Robert Hsiung, MD,
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Posted by WirelessWally on September 24, 2006, at 14:35:45
In reply to Re: Emsam: constant dosing? » WeeWilly, posted by Jost on September 24, 2006, at 10:41:29
> I do think Emsam would work as monotherapy. I had used provigil for a long time because of insomnia, and insomnia was a problem when I first started the Emsam, and for quite a while. It has started to get better, and I have no more problem than before I started. It's really a good idea, if you have insomnia, to take the patch off for five or six hours (or even more) at night. It helped me stay with the Emsam, because the insomnia was quite bad. I often wake up anyway, and so I put it on toward the end of my sleep-- and can sleep a few more hours without much trouble.
>
> My pdoc said he has eight patients on Emsam, who are doing well. I don't know if they're also had insomnia problems, but that's been mentioned here pretty frequently.
>
> The energy I get from Emsam helps a lot, even on days without quite enough sleep, so I wouldnt necessarily need the provigil either. But on some days, it helps.
>
> Provigil a pretty benign drug, from what I've seen and has some AD effects, too. Nothing like the stronger stimulants like adderall, or dexedrine.
>
> My recent problem was from what seems to be an overdose, possibly from defective packets, and exercising in the heat. I don't think the dose I got would be a normal thing-- but be cautious about heat, such as baths, hottubs, saunas, heating pads. Heat seems to increae the dose quite a bit, especially if you absorb the drug easily. (The delivery system doesn't have a precise target amount, but rather a range of absorption.)
>
> Maybe your pdoc would be more open to provigil. If not, I'd try the Emsam anyway. My advice (which might not be right for you, of course) would be not to go up too quickly on the dose for Emsam, esp. if you get irritability or the insomnia.
>
> Good luck! I hope it works out for you.
>
> JostJost, Just read your post. I have been on EMSAM for about 7wks. now. I am also on Risperdal (.5mg/day). I started the fist month at the 6mg dosage and at the third week found I had a ton of energy but lacked much joy in my life. At the 4mo. period the doc moved me up to the 9mg patch. At this dose I have been on for three weeks. I have lost much of my energy and seem more mellow. I do have joy in my life but miss the energy I had at the 6mg dosage. I have not heard of Provigil and wonder if that would help me gain some energy back. My blood pressure has dropped dramatically at this dose and no longer take any BP meds. It seems that I have also lost the laughter and joking around I used to do. I wonder if any of this will return the longer I stay at this dosage. No real insomnia but i do wake up early (6:00am) So far I like the way I emotionally feel but miss the energy. I feel like I have had a personality change of sorts because I used to always be joking and laughing even when depressed, it just felt forced or false. I have been thinking about going back to the 6mg dose but will wait it out if the energy and laughter would return in due time. I see the doc on the 6th of Oct and do not yet know what direction to take. The doc is open to my suggustions as long as they are within reason. Your Thoughts? Wally
Posted by teddi52 on October 3, 2006, at 8:00:57
In reply to Re: Emsam: constant dosing? » Jost, posted by WeeWilly on September 21, 2006, at 22:55:11
Has anyone experienced severe neck and upper back pain on EMSAM. I have cervical dystonia, and cannot continue EMSAM because of the pain I am experiencing. Any suggestions. I was on 6 mg for 2 weeks with minor pain, then 12 mg for two weeks with severe pain. Thanks
Posted by crimsonvik on November 1, 2006, at 15:09:04
In reply to Re: EMSAM - First Day -- what to try for insomnia?, posted by ttee on July 21, 2006, at 0:11:54
My Dr. says I CAN take Benadryl on the patch. Yaah!
Posted by Jeffy on November 26, 2006, at 18:03:08
In reply to Re: Emsam Price, posted by SFY on September 6, 2006, at 12:56:29
Hi.
Do you REALLY have to be off SSRI's BEFORE you take Selegiline or Tianeptine?
Grateful for any insight, thanks!
- Jeffy.
Posted by Phillipa on November 26, 2006, at 19:27:11
In reply to SSRI waiting time?, posted by Jeffy on November 26, 2006, at 18:03:08
Someone who just started EMSAM said one week on the leaflet in the box after stopping an SSRI. But my pdoc said two weeks. Google the site to be safe Love Phillipa
Posted by Jeffy on November 26, 2006, at 20:35:55
In reply to Re: SSRI waiting time? » Jeffy, posted by Phillipa on November 26, 2006, at 19:27:11
Thanks, P - anyone else? - Jeff.
> Someone who just started EMSAM said one week on the leaflet in the box after stopping an SSRI. But my pdoc said two weeks. Google the site to be safe Love Phillipa
Posted by stargazer on November 27, 2006, at 12:16:53
In reply to Re: SSRI waiting time? » Phillipa, posted by Jeffy on November 26, 2006, at 20:35:55
According to EMSAM package insert, a time period equal to 4-5 half lives (approx 1 week) of treatment with SSRI's, SNRI's, TCA's, MAOI's, meperidine and other analgesics (listed in package insert) should elapse before starting Emsam.
The exception is for prozac where you should wait 5 weeks due to it's long half life. Buspar requires 2 week washout. Those are the only two exceptions to the 1 week rule.
Stargazer (Ensam day 10+)
Posted by Jeffy on November 27, 2006, at 12:23:55
In reply to Re: SSRI waiting time?, posted by stargazer on November 27, 2006, at 12:16:53
Thanks Stargazer and best of luck with the patch. Anyone else on waiting time? - Jeffy.
Posted by Jeffy on November 27, 2006, at 12:24:23
In reply to Re: SSRI waiting time?, posted by stargazer on November 27, 2006, at 12:16:53
Thanks Stargazer and best of luck with the patch. Anyone else on waiting time? - Jeffy.
Posted by ryanz on January 2, 2007, at 16:43:16
In reply to Re: EMSAM - First Day -- what to try for insomnia? » mayzee, posted by SFY on July 20, 2006, at 13:51:19
According to what I've read, benadryl is technically not supposed to be used with MAOI's, nor is Tylenol according to at least one source.
(Benadryl is the active ingredient in over-the-counter sleep aids as well, for those who weren't aware of this).It seems like it would go doubly so for Benadryl, because it also acts as an SSRI, although most people do not know this. And SSRI's are also contraindicated while taking MAO inhibitors.
But, has anyone taken benadryl as a sleep aid or for allergies with EMSAM, and did you have any problems? Thanks.
Posted by CrimsonVik on January 2, 2007, at 16:51:54
In reply to Re: EMSAM: taking it with benadryl/diphenhydramine, posted by ryanz on January 2, 2007, at 16:43:16
Benadryl is about the only medication of that type we can use. I use it all the time when I don't have Ambien.
If you're concerned, check Benadryl's label. There is no MAOI warning on it.
My Dr. told me all this initially.
Vik> According to what I've read, benadryl is technically not supposed to be used with MAOI's, nor is Tylenol according to at least one source.
> (Benadryl is the active ingredient in over-the-counter sleep aids as well, for those who weren't aware of this).
>
> It seems like it would go doubly so for Benadryl, because it also acts as an SSRI, although most people do not know this. And SSRI's are also contraindicated while taking MAO inhibitors.
>
> But, has anyone taken benadryl as a sleep aid or for allergies with EMSAM, and did you have any problems? Thanks.
Posted by ryanz on January 2, 2007, at 17:33:19
In reply to Re: EMSAM: taking it with benadryl/diphenhydramine » ryanz, posted by CrimsonVik on January 2, 2007, at 16:51:54
> Benadryl is about the only medication of that >type we can use. I use it all the time when I >don't have Ambien.
> If you're concerned, check Benadryl's label. >There is no MAOI warning on it.
> My Dr. told me all this initially.
> Vik
>You're probably right, but to be fair:
I checked for a drug interaction between parnate and benadryl at drugs.com and it shows a moderate drug interaction (basic warning about taking Benadryl and other antihistamines with MAOI's).
Also, Benadryl does reportedly potently block the reuptake of serotonin, although most psychiatrists and pharmacists probably don't even know this.
Posted by CrimsonVik on January 2, 2007, at 20:19:24
In reply to Re: EMSAM: taking it with benadryl/diphenhydramine, posted by ryanz on January 2, 2007, at 17:33:19
If you're worried about it then of course don't take it.
I also take the same ingredient in the PM meds like Tylenol PM. It's what's in Benadryl. I prefer not to take Tylenol too much though because it's bad on the liver.Vik
Posted by laima on January 3, 2007, at 8:21:53
In reply to Re: EMSAM: taking it with benadryl/diphenhydramine » ryanz, posted by CrimsonVik on January 2, 2007, at 20:19:24
I've never had any problem taking Benedryl with Emsam either- my doctor and pharmacist both said it was fine.
Posted by ramsea on January 3, 2007, at 8:36:10
In reply to Re: EMSAM: taking it with benadryl/diphenhydramine » ryanz, posted by CrimsonVik on January 2, 2007, at 20:19:24
how much tylenol is bad on the liver? i use it everyday, 2-3 tablets. thanx
Posted by CrimsonVik on January 3, 2007, at 9:59:07
In reply to tylenol and liver » CrimsonVik, posted by ramsea on January 3, 2007, at 8:36:10
I thought it was only drinkers who shouldn't take too much, but it's not. I don't know the exact amount but I wouldn't go over the 3 a day. Ask your Dr. though.
My husband saw a TV show the other day on Discovery about it on Dr. G, Medical Examiner.
Vicki> how much tylenol is bad on the liver? i use it everyday, 2-3 tablets. thanx
Posted by laima on January 4, 2007, at 9:48:17
In reply to Re: tylenol and liver » ramsea, posted by CrimsonVik on January 3, 2007, at 9:59:07
If you google tylenol and liver, you'll get a lot of specifics. They say that some people can have liver trouble even when using it according to package instructions. Trouble can occur with advil and other NSAIDS, too.
Posted by jenro on February 25, 2007, at 14:17:52
In reply to Re: EMSAM - 30+ day questions, posted by WirelessWally on August 27, 2006, at 12:34:59
I've been on emsam 6mg for 5 weeks now. Like some others here I feel more active but don't feel better, i.e. more hopeful, etc. I started with lamital about 10 days ago, still pretty anhedonic. I've also tried the DL-phenylaline with it. Still, up at at things but with my mood is still not much improved. (In the past had real mood boost with lexipro and geodon but both pooped out eventually.) Though, now I'm thinking of getting off the emsam and getting back on those. The psychpharm says it's still too early to tell re the emsam. Have people had really good responses to emsam suddenly on their 6th week? Seems unlikely to me. I don't want to go up on the emsam because of the irritability effect which I'm experiencing quite a bit of on this dose. I guess my ? is: What combinations have worked for people w/ emsam? any ideas out there for treating anhedonia and irritation?
Posted by laima on February 26, 2007, at 7:36:42
In reply to Re: EMSAM - HAVE PEOPLE STAYED ON IT W/SUCCESS?, posted by jenro on February 25, 2007, at 14:17:52
It's been working out for me- selegeline/Emsam for about a year now, or longer. I didn't get much out of the "6" though- perhaps that dose is too low for some people? The "9" has worked much better. I tried the "12", but Emsam significantly lowers my blood pressure, and the highest patch really made me feel disfunctionaly faint, dizzy when I stood up, etc. Maybe try to up your dose? Why not up the dose before giving up on it? It can be a good med, and with such a beneign side efect profile compared to so many others. Mine worked alright for most of the time, then started fading, but after a few different augmentation strategies, the one that became the magic combo (for me) turned out to be Emsam/brand name Adderall. (I ultimately did not get good result from generic amphetamine, Barr brand.)
Posted by laima on February 26, 2007, at 7:41:21
In reply to Re: EMSAM - HAVE PEOPLE STAYED ON IT W/SUCCESS?, posted by jenro on February 25, 2007, at 14:17:52
By the way, yes, both Emsam and oral selegeline seem to take a while to "kick in".
Posted by Honore on February 26, 2007, at 10:55:26
In reply to Re: EMSAM - HAVE PEOPLE STAYED ON IT W/SUCCESS? » jenro, posted by laima on February 26, 2007, at 7:36:42
Does anyone know about the generics for ritalin? I;m using it with Emsam because right now I'm not getting much sleep (using emsam and a small amount of abilify-- think it's the abilify which, whiile very good for me, is pushing things further in the non-sleeping direction).
I had some leftovers from a very old ritalin generic prescription, which I used; then I started a recent prescription, also a generic. The new generic (methylin) has no discernible effects at the same dose as the older one (if i use 2x it is noticeable).
Is there a particular generic ritalin that's better than others? Or is the non=generic ritalin significantly better than the generics?
thanks, Honore
Posted by jenro on February 26, 2007, at 12:38:46
In reply to Re: EMSAM - generics aigmentation / ritalin, posted by Honore on February 26, 2007, at 10:55:26
Unfortunately, I don't have any experience with ritalin so I don't know about the generics issue.
I'm very interested to hear that you are taking emsam and some abilify. I've been trying to get my doc to put me on a small dose of either geodon or lexipro w/emsam and they won't do it.
Has anyone else taken emsam with a small dose of abilify, geodon or lexipro?
Posted by laima on February 26, 2007, at 17:47:20
In reply to Re: EMSAM - generics aigmentation / ritalin, posted by Honore on February 26, 2007, at 10:55:26
I used to use ritalin with Emsam- I never noticed a difference between generic and brand for this med, but have heard that some people do. Sorry, don't remember the name of the generic I used.
Posted by d0pamine on March 25, 2007, at 3:54:47
In reply to Re: EMSAM - HAVE PEOPLE STAYED ON IT W/SUCCESS?, posted by jenro on February 25, 2007, at 14:17:52
For me, emsam has done what no other ad med has had the capacity to do (and I’ve tried quite a few). I've used it for about 10 months and would currently consider myself to have progressed to a long awaited state of relatively blissful functional normalcy. For the record it took about 6 weeks to even begin to work for me, but continued to improve for at least the first 6 months (no kidding) as the beneficial effects increased and the side effects faded (other than these occasional but quite tolerable jerks). I'm on the 12mg patch btw.
Also for a time at one point some months ago I tried combining DL-phenylalanine and it almost entirely eliminated the positive effects derived from use of emsam. This downturn was perceivable about 2 days into the experiment was realized on the third and persisted for another 3 or 4 after DLP was discontinued. Perhaps mine was an isolated case confined to my own peculiar body chemistry, but based on my experience, I'd highly recommend avoid this combo, particularly if your condition hasn’t improved sufficiently to provide enough perspective to recognize a downturn.
Posted by chiron on March 26, 2007, at 22:21:29
In reply to Re: EMSAM - HAVE PEOPLE STAYED ON IT W/SUCCESS?, posted by d0pamine on March 25, 2007, at 3:54:47
it took 6 weeks? did you feel anything in those first 6 weeks? what did you feel like before? do you relate to a general feeling of instability?
-thx
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