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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by helpme on July 4, 2006, at 17:34:14
Is this why I'm so exhausted, REALLY exhausted??? What about the amphetamine metabolites i heard about?
Posted by iforgotmypassword on July 4, 2006, at 17:50:01
In reply to Can Emsam/selegeline make you tired?, posted by helpme on July 4, 2006, at 17:34:14
Posted by helpme on July 4, 2006, at 18:29:37
In reply to check your blood pressure (nm) » helpme, posted by iforgotmypassword on July 4, 2006, at 17:50:01
Thank you for your response. You know, my blood pressure is always so low, EMSAM or no EMSAM, that doctors always do a double take- but then say something like, "you must be an athelete, oh you are so lucky...the lower the better" Blah. I don't buy it. But my current doc has me on 15 mg of ritalin in addition to the emsam to raise my blood pressure, but it hasn't worked. Honestly barely dented it at all. I am usually around 100 (or even less) over 70 or 80- even after moderate exertion. That's low, isn't it? I want more ritalin. I see my doctor in a few days and I really, really hope I get more ritalin or something stronger like dexedrine. I feel so incredibley deflated, like a limp balloon most of the time. I also used to drink coffee in efort to raise my blood pressure, but all that happened is I hurt my stomache. Before EMSAM, I drank plenty of wine with selegeline- also no effect. I also have been advised by another doctor, "Feel free to eat all the salt you want". Am I weird? I have my very own blood pressure monitor, per my doctor's request, so I keep a close eye on it. The pharmacy has a cow every time I get the prescriptions filled because it is an MAOI with a stimulant. I wonder why my blood pressure is so low, and if it is a key to why I have had treatment resistant depression for eons.
Posted by mayzee on July 4, 2006, at 19:17:08
In reply to Can Emsam/selegeline make you tired?, posted by helpme on July 4, 2006, at 17:34:14
I am also terribly fatigued on EMSAM. At least during the day. Then at bed-time I am more alert.
I have just finished week 6 on the 6mg patch. On Day 6 I had alot of energy --very unusual for me; thought the med was kicking in. But the next day I crashed and haven't had any more up days since. That's also about when the insomnia side effect kicked in for me. The insomnia went away over the past few weeks; but my sleep is still very restless & I wake up frequently. (Previously, one of my biggest problems was hypersomnia -- I could sleep all day & still sleep all night) I was on Wellbutrin prior to EMSAM, and I guess I wasn't as fatigued, because I feel like it's alot worse now. I also tend to have low blood pressure, but don't have a monitor so don't know how it's been since I started EMSAM.
At 6mg, I have been feeling more depressed & tired. No AD benefits at all yet. Other side effects I've had: diarrhea, GI discomfort, flatulence, increase in crying, spacey feeling, appetite increase, dry eyes, orthostatic hypotension; all pretty mild but more than I've had on other ADs.
So now I'm trying to decide on going up to the 9mg patch. >>> Did anyone else feel *worse* at 6mg and then better at a higher dose? <<< I thought most people who went up in dose had gotten at least some AD effects at 6mg.
Sorry to go on so long. I've been reading here for a few weeks but just got an ID to post. My Dx is major depressive disorder, recurrent & severe; atypical (*hypersomnia*, *anhedonia*, hypersensitivity to rejection, etc.) I have anxiety related to my not feeling good enough, but have always focused on meds for the depression. Have previously tried Zoloft, Effexor, Prozac, Wellbutrin, Luvox, Lexapro, Cymbalta. The only benefit I got was that I wouldn't cry. Only augmentation tried was Paxil + Wellbutrin. I'm kind of med-phobic and very uneasy about trying new meds or combinations. Had been told long ago that MAOIs are the best for atypical depression so was really counting on EMSAM (as were many others posting here!)
Thanks to all the EMSAM posters. You're really helping me!
Posted by helpme on July 4, 2006, at 19:54:01
In reply to Re: Can Emsam/selegeline make you tired?, posted by mayzee on July 4, 2006, at 19:17:08
Fascinating. My experience is so much like yours, including details like initial up, then crash, fatique, dry eyes, GI trouble. Also severe nausea. Right now I'm in a hypersomnia phase, and can't seem to snap out of it. My skin has suddenly turned super dry, too--except acne, new for me. I feel these days are lost, useless. I wish I was more alert at bedtime- I'm not. Last night I was alseep by 7pm and it's been like that a lot, so tonight now it's 8 and I'm up and it feels late.
My doctor did warn me that selegeline can cause low blood pressure in some patients, and that small amounts of stimulants can help them and are often safely prescribed for this very reason despite conventional warnings against this practice. Great! I already have low blood pressure, so now it must be worse. But so far, "small amount of stimulant" is having no effect.
I also have atypical depression, and most of the drugs you mentioned failed me and some even made me feel suicidal. I'm taking the 6mg EMSAM now, but at my next doctor appointment I am going to have to say something. I want more stimulant.
Posted by Phillipa on July 4, 2006, at 22:01:02
In reply to Re: Can Emsam/selegeline make you tired?, posted by helpme on July 4, 2006, at 19:54:01
Have either of you tried lamictal with the EMSAM I know someone who has just tried this. Love Phillipa
Posted by mayzee on July 5, 2006, at 9:12:54
In reply to Re: Can Emsam/selegeline make you tired?, posted by Phillipa on July 4, 2006, at 22:01:02
No, I haven't tried Lamictal. I've been thinking of trying Provigil though.
Posted by helpme on July 5, 2006, at 9:18:04
In reply to Re: Can Emsam/selegeline make you tired?, posted by mayzee on July 5, 2006, at 9:12:54
Forget lamical- it can make you fuzzy, headachey, nauseous and dumb. But if you can get it, provigil is awsome! It makes you awake but not wired, and smarter. It is supposedly not even a stimulant, and didn't interfere with sleep. I got no side effects from it at all, but ultimately found ritalin worked better for me because i need to raise my blood pressure..
Posted by bassman on July 5, 2006, at 9:39:07
In reply to Re: check your blood pressure, posted by helpme on July 4, 2006, at 18:29:37
If you look on the internet, even 80-90/50 isn't considered hypotension unless you have symptoms...
Posted by Crazy Horse on July 5, 2006, at 10:19:27
In reply to Can Emsam/selegeline make you tired?, posted by helpme on July 4, 2006, at 17:34:14
> Is this why I'm so exhausted, REALLY exhausted??? What about the amphetamine metabolites i heard about?
Any antidepressant can make you tired. However it is propably a side-effect that will fade in time..hopefully.
Monte
Posted by helpme on July 5, 2006, at 10:33:50
In reply to Re: check your blood pressure, posted by bassman on July 5, 2006, at 9:39:07
Well I don't know- does sluggishness, brain fog, weakness, periodic borderline anemia, fatigue, and being cold count as symptoms? Are there other symptoms I should know about?
Did some interesting research last night, and found stuff that suggests that while US and UK doctors think low blood pressure is fine, Germans consider it a medical problem to be treated and associate it with fatique and depression. Germans are smart people...so I don't discount them. The numbers seem to vary depending on the source. Every doctor who every takes my blood pressure, however, reacts with disbelief and double checks it a few times, so I know it's unusual.
> If you look on the internet, even 80-90/50 isn't considered hypotension unless you have symptoms...
Posted by helpme on July 5, 2006, at 10:35:17
In reply to Re: Can Emsam/selegeline make you tired? » helpme, posted by Crazy Horse on July 5, 2006, at 10:19:27
Thanks. What about all the people who say they put the patch on at night- does that mean they get an amphetamine metabolite rush in the morning? Maybe I'll experiment.
> > Is this why I'm so exhausted, REALLY exhausted??? What about the amphetamine metabolites i heard about?
>
> Any antidepressant can make you tired. However it is propably a side-effect that will fade in time..hopefully.
>
> Monte
Posted by Phillipa on July 5, 2006, at 18:57:10
In reply to Re: check your blood pressure, posted by helpme on July 4, 2006, at 18:29:37
Helpme you are very lucky to have that blood pressure it's not too low. Less strain on your heart. And puts you in a category for less cardiac diseases, kidney problems, stroke. Very lucky indeed. Love Phillipa
Posted by Phillipa on July 5, 2006, at 19:09:42
In reply to Re: check your blood pressure, posted by helpme on July 5, 2006, at 10:33:50
Wow!!!!have you had your thyroid checked and are you taking iron for the anemia. Both cause fatigue. Love Phillipa former nurse
Posted by helpme on July 5, 2006, at 19:56:25
In reply to Re: check your blood pressure » helpme, posted by Phillipa on July 5, 2006, at 19:09:42
Yes, thank you- I get my thyroid checked pretty often it seems- and they always claim it's fine. I took iron for anemia and that seems to have been corrected for now thankfully. But it runs in the family, so i don't rule it out from coming back. I am curious about other anemias I've heard of but they never seem to check for- stuff like B vitamins. Could those cause severe fatigue/brain fog?
Posted by Jost on July 5, 2006, at 21:04:17
In reply to Re: check your blood pressure, posted by helpme on July 5, 2006, at 19:56:25
Have you looked into the possibility that the klonopin is causing the tiredness?
You may have gotten into one of those binds of using stimulants, then counteracting the stimulant by using benzos.
I'm relieved to read (below) that you'll see your Dr. before trying to withdraw from the benzos. The dose of klonopin is very high, and you really need to come off it appropriately. Otherwise, you could risk medication consequences.
Is the Dr. aware of the different meds you're using? If s/he isn't, please give him/her a full description, because this combination of drugs could be a trap that you can't address with one doctor knowing/ helping with one med and a different Dr. with another. To give yourself a chance of recovery, someone needs to have the complete picture.
Best of luck.
Jost
Posted by Phillipa on July 5, 2006, at 21:07:42
In reply to Re: check your blood pressure, posted by helpme on July 5, 2006, at 19:56:25
Do a google search of types of anemia and treatment. I google all my meds and practically everything as well. Love Phillipa
Posted by helpme on July 6, 2006, at 7:54:50
In reply to Re: check your blood pressure, posted by Jost on July 5, 2006, at 21:04:17
You bet- I want off klonopin, I find it has a long hangover--but it is a VERY addictive drug and I am really having a rough time with it. I take it at night, and even at 2mg, I detect a "fuzz" late the following day if I pay attention. I think it is very obvious that it cancels out a portion of the ritalin.
All the meds are from same doctor, he just doesn't know the extent of the benzo problem.
He is considered one of my regions top psychoparmacologists...but I just don't now what to think anyway.
> Have you looked into the possibility that the klonopin is causing the tiredness?
>
> You may have gotten into one of those binds of using stimulants, then counteracting the stimulant by using benzos.
>
> I'm relieved to read (below) that you'll see your Dr. before trying to withdraw from the benzos. The dose of klonopin is very high, and you really need to come off it appropriately. Otherwise, you could risk medication consequences.
>
> Is the Dr. aware of the different meds you're using? If s/he isn't, please give him/her a full description, because this combination of drugs could be a trap that you can't address with one doctor knowing/ helping with one med and a different Dr. with another. To give yourself a chance of recovery, someone needs to have the complete picture.
>
> Best of luck.
>
> Jost
Posted by helpme on July 6, 2006, at 7:55:57
In reply to Re: check your blood pressure » helpme, posted by Phillipa on July 5, 2006, at 21:07:42
Thanks Phillipa,
I do that too! Anemia under control-for now.
This is the end of the thread.
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