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Dr. Bob is Robert Hsiung, MD,
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Posted by jkshrews on July 26, 2006, at 8:32:50
In reply to Re: EMSAM doing nothing » Donna Louise, posted by iamme2 on July 12, 2006, at 11:00:09
Megan,
Lowering the blood pressure might be the most common side-effect of MAOIs. One is sold as a high blood pressure remedy--I think Eutonyl. But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
jkshrews
> Donna,
>
> After speaking to the doc he said the emsam was probably causing my blood pressure to dip and to discontinue use of it. I'll call him tomorrow to report how I'm feeling, but I do feel better than when I was on it. Do you (or anybody) know if taking lamictal alone for depression is worth it?
>
> Megan
Posted by mayzee on July 26, 2006, at 8:52:13
In reply to Re: EMSAM doing nothing, posted by jkshrews on July 26, 2006, at 8:32:50
> But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
>
> jkshrews
>
Thanks for that suggestion. I am having trouble with low blood pressure caused by Emsam (light-headedness, dizziness, darkened vision, headache, etc.) My doctor suggested drinking lots of water & eating salty foods. I'll go get some salt tablets.Anyone have any other suggestions for dealing with low blood pressure, please let me know.
Thanks!
mayzee
Posted by Donna Louise on July 26, 2006, at 14:47:51
In reply to how to treat Low Blood Pressure caused by Emasam, posted by mayzee on July 26, 2006, at 8:52:13
> > But I would not discontinue an MAOI because of this problem. Just try some salt tablets from the drug store. "Thermotabs" is the brand I recall seeing. A few of those each day will increase your blood volume, plus put some much-needed potassium into your diet. But get them now, while it's hot outside. In the winter, the stores usually don't stock them.
> >
> > jkshrews
> >
>
>
> Thanks for that suggestion. I am having trouble with low blood pressure caused by Emsam (light-headedness, dizziness, darkened vision, headache, etc.) My doctor suggested drinking lots of water & eating salty foods. I'll go get some salt tablets.
>
> Anyone have any other suggestions for dealing with low blood pressure, please let me know.
>
> Thanks!
>
> mayzeeSomthing really weird is happening with my bp. Since starting Emsam, it has been 90 something over 60 something most of time but I have had no bad effects from that. What is weird is, if I go to long without eating, it shoots way up there. Like once when I went almost 9 hours it went to 173/105. (The higher the bp, the lower the pulse btw, and vice versa). Within 30 minutes after eating it starts dropping and within and 1 1/2 hours it is down to its usual low MAOI readings. I have never had this before, that I know of. Maybe I have and just didn't notice because I have never taken my bp several times a day before either. Since I have started since the patch. I wanted to make sure it didn't get to low and instead I discover this weird phenomena. Does anyone know if low blood sugar can cause high bp? It is the only theory I have at the moment and have not had time to research it.
Thanks,
donna
Posted by Phillipa on July 26, 2006, at 20:51:38
In reply to Re: how to treat Low Blood Pressure caused by Emasam » mayzee, posted by Donna Louise on July 26, 2006, at 14:47:51
Donna there's a medical term for this a widening pulse but a technical name. This is not normal and I believe you need to deal with it proptly don't know but don't think it's the med. Call your doc ASAP or the ER and see what they say. Seriously not trying to scare you. Love Phillipa
Posted by Donna Louise on July 27, 2006, at 6:54:52
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Donna Louise, posted by Phillipa on July 26, 2006, at 20:51:38
> Donna there's a medical term for this a widening pulse but a technical name. This is not normal and I believe you need to deal with it proptly don't know but don't think it's the med. Call your doc ASAP or the ER and see what they say. Seriously not trying to scare you. Love Phillipa
Are you speaking specifically about this happening only when you wait too long to eat? And when it is resolved immediately after eating? I would like to know the name of what you mention so I can research it. I have already spoken with my dr.donna
Posted by naughtypuppy on July 27, 2006, at 9:02:21
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Phillipa, posted by Donna Louise on July 27, 2006, at 6:54:52
My pdoc recomended eating a little bit of aged cheese several times a day with Nardil to bring my base bp of 90/50! up to a higher level. Increases Tyramine level. I was hitting the floor several times a day going into convulsions. Still get dizzy, but it seems to help, and I like the cure. Better than another taking another pill!
Posted by t2green01 on July 27, 2006, at 9:15:10
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by naughtypuppy on July 27, 2006, at 9:02:21
that doesnt sound right at all
Posted by hermansmom on July 27, 2006, at 14:29:53
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by t2green01 on July 27, 2006, at 9:15:10
I have recently gone off of cymbalta and have experienced helliosh withdrawal symptoms. I, like many of you have been on virtually every SSRI and have been treatment resistant. I have an anxiety disorder, major depression, and agoraphobia. I saw my pdoc yesterday, and he gave me emsam samples (6mg) and wants me to try it for 2 weeks. I also take clonazepam (klonipin) and Rozarem (sp?) a sleep RX. I gained a gang of weigth on Cymbalta about 60 pounds in 7-8 mos. Since going off it 22 days ago, i have lost 7 lbs (still look like a fat beast, but going down is better than up!) The weight gain has worsened my depression, and social anxiety-frankly, I just feel fat and disgusting and at my wits end!!!I have been off work for 2 years and pdoc has suggested ECT, but I'm scared of that, now, too. The Cymbalta experience (increased suicidal ideation, including hospitalization for suicide attempt, and withdrwal symptoms from hell) has made me reluctant to try yet another guinea pig drug. I am curious about potential psych side effects,as well as weight gain, I already have low BP, and wonder if there are withdrawal effect from this as with Cymbalta. If you google cymbalta withdrwal you'll get an idea of what I mean. I am so scared and so desperate! I know the weight gain thing may just sound like a vanity thing, but it really has put a huge dent in my self image and increased my dpression. I already feel gross and worthless enough.
Posted by t2green01 on July 27, 2006, at 15:40:14
In reply to new to emsa and SCARED!!!!, posted by hermansmom on July 27, 2006, at 14:29:53
Hermansmom.......
My story sounds 110 percent the same as yours. I was very scared to start the Emsam. I have been through all of the ssri's and combos of them. Im a hundred and ten pounds heavier then I was 5 years ago. Since the anxiety and depression has started I just have been existing each day. I havent been a good dad, friend etc etc.... I have been on emsam for 4 days. I was scared to start taking it but I want to live and overcome this crappola. If eating elephants terds cured depression I would... well you know what I'm saying. We do what we have to do and If you scare yourself to death of a med there is pretty much no way it will help in my opinion. You have to believe your condition is going to improve. Damn, I sound like one of those motivational speakers.
I have been pretty pleased with Emsam. Im only 4, almost 5 days into it but I believe it is helping. Keep me updated of how you are doing and I will do the same 4 u .
Here are a couple sites you might like to read:My insurance has approved me for VNS therapy. I have that as a option in the near future.
Posted by laima on July 27, 2006, at 17:07:10
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by t2green01 on July 27, 2006, at 9:15:10
> that doesnt sound right at all
I asked my doctor about that (eat some cheese" option, too- but he was horrified at the thought- said it was not quite...I gathered there are other chemical processes going on than than merely raising blood pressure this way?
Posted by mayzee on July 27, 2006, at 19:12:09
In reply to new to emsa and SCARED!!!!, posted by hermansmom on July 27, 2006, at 14:29:53
Hermansmom,
I've been on Emsam 2+ months now; am on the 9mg patch now. I haven't experienced any weight gain. I've been trying to read all the posts here related to Emsam and I don't remember anyone saying they were gaining weight on it. So hope that helps. Good luck & please let us know how it goes.
Best wishes,
mayzee
Posted by Phillipa on July 27, 2006, at 20:54:24
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Phillipa, posted by Donna Louise on July 27, 2006, at 6:54:52
What I don't understand is what your blood pressure has to do with eating? I can understand it lowering your blood sugar. And I'm glad you talked with your doc. So does he know a lot about EMSAM? Since it's so new? Love Phillipa
Posted by Phillipa on July 27, 2006, at 21:01:08
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Phillipa, posted by Donna Louise on July 27, 2006, at 6:54:52
Donna I forgot to say if anything waiting a long time to eat and causing low blood sugar would probably if it even effected it lower your BP. Love Phillipa now maybe EMSAM has a mechanism that creates something abnormal like that. I don't know. Love Phillipa
Posted by mayzee on July 27, 2006, at 21:23:58
In reply to Re: how to treat Low Blood Pressure caused by Emasam » mayzee, posted by Donna Louise on July 26, 2006, at 14:47:51
When I was looking online for info about low blood pressure, I found this on the Wikipedia site for orthostatic hypotension, in the section titled "Lifestyle advice. Some suggestions for minimizing the effects [of orthostatic hypotension] include: ... As eating lowers blood pressure, eating multiple smaller meals rather than fewer larger meals." http://en.wikipedia.org/wiki/Orthostatic_hypotension
So there is that link between eating and bp.
Posted by laima on July 27, 2006, at 21:46:17
In reply to new to emsa and SCARED!!!!, posted by hermansmom on July 27, 2006, at 14:29:53
Dear hermansmom,
I had an awful experience with cymbalta, too: suicidal, immediately. I'm on EMSAM 9 now, after starting on the 6, and am delighted to report that on day 3, I scarcely dare say- I think it's starting to work! Unwanted weight gain is definately not a pleasant experience, and having experienced bewildering weight gain with some tricyclics and ssris, I wish to express empathy for what you are going through. Though it sounds promising what you already report about your recent weight loss! I don't think you are being vain. If, as it was for me, the weight is not what you want, that's how it is. I had always been so skinny when younger, my gain was an utter shock, and I confess, I wanted to fit into clothes a certain way and such. It did affect my self esteem. You might be encouraged to know my own weight gain went away, after I ended ssris and went through a stepped up excercise program for awhile (which also lifted my mood.) Of course, I pass no judgement on people who of course come in all sizes- but if the gain is unwanted, you need to buy new clothes but none fit, and especially if one is female, etc., -it might not be politically correct to admit- but sometimes one still in fact just ends up wanting to change size. A therapist I once had and greatly respected (before she retired) told me, "Well- you are not really fat and you are not too skinny-you are a teeny hefty-though not a lot-nothing wrong there-but if you want to lose some weight- go for it rather than wonder about it." I guess what I mean to say is, I think what I learned from her was that if you feel better about yourself and how you look and feel at a different weight than where you are-and your assessments and expectations are reasonable and not extreme, I don't think you are being vain. It also doesn't mean you are making any judgements about others. And I also think you have reported some encouraging developments towards where it sounds that you want to go. I really think we feel better when we feel have some control over our bodies and feel more attractive-whatever that means for an individual. Hope that makes sense and isn't misinterpretable.
Very sincere best wishes,
Laima
> I have recently gone off of cymbalta and have experienced helliosh withdrawal symptoms. I, like many of you have been on virtually every SSRI and have been treatment resistant. I have an anxiety disorder, major depression, and agoraphobia. I saw my pdoc yesterday, and he gave me emsam samples (6mg) and wants me to try it for 2 weeks. I also take clonazepam (klonipin) and Rozarem (sp?) a sleep RX. I gained a gang of weigth on Cymbalta about 60 pounds in 7-8 mos. Since going off it 22 days ago, i have lost 7 lbs (still look like a fat beast, but going down is better than up!) The weight gain has worsened my depression, and social anxiety-frankly, I just feel fat and disgusting and at my wits end!!!I have been off work for 2 years and pdoc has suggested ECT, but I'm scared of that, now, too. The Cymbalta experience (increased suicidal ideation, including hospitalization for suicide attempt, and withdrwal symptoms from hell) has made me reluctant to try yet another guinea pig drug. I am curious about potential psych side effects,as well as weight gain, I already have low BP, and wonder if there are withdrawal effect from this as with Cymbalta. If you google cymbalta withdrwal you'll get an idea of what I mean. I am so scared and so desperate! I know the weight gain thing may just sound like a vanity thing, but it really has put a huge dent in my self image and increased my dpression. I already feel gross and worthless enough.
Posted by laima on July 27, 2006, at 22:02:16
In reply to Emsam, et. al, posted by Kirkster on July 10, 2006, at 12:19:02
Dear Kirkster-
EMSAM not nearly as scary or dangerous as the other MAOIS. Hence the huge news buzz around it, heralding it as a major breakthrough development.
I hear that even on a higher dose, if you slip up with food, you are most likely still absolutely safe. And I can only speak for myself, but I've experienced scads of side effects with most drugs, but nothing remarkable at all with EMSAM.Best wishes,
Laima
> Confused about EmSam -
> I was diagnosed as Bipolar Depression (cycle from norm. to depressed) and put on Lithium and Lamictal and doing great until Lithium toxicity (lots of fun!). I went down a bit on Lithium and so did my mood - big time. Now back up halfway on Lithium and not doing too well. Now my doc wants to try Emsam, but the idea of a MAOI is scary to me - been on every SSRI known to man, but not sure about trying Emsam. Is it worth a try or are the side effects so bad I should run away from it.
>
> Kirkster
Posted by laima on July 27, 2006, at 22:05:43
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Donna Louise, posted by Phillipa on July 27, 2006, at 20:54:24
>So does he know a lot about EMSAM? Since it's so new? Love Phillipa
I noticed and speculate ...some doctors are really into research and have ties to drug trials and follow them avidly, whereas others are more patient focused instead of research focused??
Posted by Donna Louise on July 28, 2006, at 6:39:12
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Donna Louise, posted by Phillipa on July 27, 2006, at 20:54:24
> What I don't understand is what your blood pressure has to do with eating? I can understand it lowering your blood sugar. And I'm glad you talked with your doc. So does he know a lot about EMSAM? Since it's so new? Love Phillipa
That is what I don't understand either. That is the question I am asking. Does anyone know about this? It is not about the EMSAM.
Posted by Donna Louise on July 28, 2006, at 6:42:20
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by mayzee on July 27, 2006, at 21:23:58
> When I was looking online for info about low blood pressure, I found this on the Wikipedia site for orthostatic hypotension, in the section titled "Lifestyle advice. Some suggestions for minimizing the effects [of orthostatic hypotension] include: ... As eating lowers blood pressure, eating multiple smaller meals rather than fewer larger meals." http://en.wikipedia.org/wiki/Orthostatic_hypotension
> So there is that link between eating and bp.
>Thanks so much, I will go to the link now. I had read that fasting lowers bp, and I am having the opposite, which I have never heard of. I have searched and been unable to find anything so thanks!
donna
Posted by jkshrews on July 28, 2006, at 10:46:39
In reply to Re: how to treat Low Blood Pressure caused by Emasam, posted by naughtypuppy on July 27, 2006, at 9:02:21
I think eating some tyramine sounds like a pretty dangerous approach to raising your blood pressure while on Nardil. (Unless, of course, you ae suicidal!) How would you know how much you are getting? Or the status of your digestive MAO on that particular day?
Here are some things to remember.
1) These drugs have been around for decades. Selegiline is an old drug--EMSAM is merely a new method of delivering it.
2) Low blood pressure has always been a troublesome side-effect for MAOIs. One MAOI, Eutonyl (pargyline) is actually sold to treat hypertension.
3) Since the 1970's, there have been two cures for the hypotension side-effect. One is salt pills, which is very safe, you can do it yourself, and it is usually very effective. The other is a metal-corticoid hormone, and I think you will have trouble finding a doctor in the U.S. that will try it.4) Having hypotention can be hard to get treated, because doctors in the U.S. usually do not consider it a pathology. I have heard that in Europe doctors regard it as a disease and in med school are taught about two dozen treatements for hypotension. I would like to know what they do over there for MAOI-induced hypotension.
> My pdoc recomended eating a little bit of aged cheese several times a day with Nardil to bring my base bp of 90/50! up to a higher level. Increases Tyramine level. I was hitting the floor several times a day going into convulsions. Still get dizzy, but it seems to help, and I like the cure. Better than another taking another pill!
Posted by Phillipa on July 28, 2006, at 20:27:07
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Phillipa, posted by Donna Louise on July 28, 2006, at 6:39:12
Donna maybe try the health board? I'm at a loss. Love Phillipa
Posted by Donna Louise on July 29, 2006, at 7:23:10
In reply to Re: how to treat Low Blood Pressure caused by Emasam » Donna Louise, posted by Phillipa on July 28, 2006, at 20:27:07
> Donna maybe try the health board? I'm at a loss. Love Phillipa
I now understand why the eating brings the bp down. It is a parasympathetic response to induce digestion which concurrently relaxes blood vessels, ect. What I now need to know is why it is shooting up in the first place and why that seems correlated to not eating. I take my pressure obsessively all day long and as long as I don't wait any longer than 5 hours to eat, it stays within a normal range. It is like 95/65 when I first wake up and that is when I have gone the longest without eating. I know bp is lowest in the morning but that period of not eating while I am asleep seems to discount the theory tha not eating is causing the bp to get too high.
Oh well, I at least know the solution if not the cause. Just don't wait for longer than 5 hours to eat. I do appreciate your concern and attempts to help me. Thanks.donna
Posted by jealibeanz on July 29, 2006, at 10:22:11
In reply to new to emsa and SCARED!!!!, posted by hermansmom on July 27, 2006, at 14:29:53
You sounds a bit like me, except my last AD was Effexor, not Cymbalta. It also caused rapid weight gain, so I D/C'd. I'm now skeptical about this aspect with any AD. I too have an anxiety disorder and insomnia. I take Xanax and Lunesta, which is no longer helping much with sleep. How do you like the Rozerem? What type of med is that? Did you doc have any concerns about EMSAM worsening insomnia and anxiety? Let me know how you're doing. Thanks:)
Posted by t2green01 on July 29, 2006, at 14:00:23
In reply to Who's Still Going Strong with EMSAM?, posted by jealibeanz on June 24, 2006, at 21:48:28
did anybody else have extreme insomnia with emsam and did it improve or did you have to medicate the insomnia. im so tired but i dont want to take more pills.
Posted by mayzee on July 29, 2006, at 17:26:52
In reply to Emsam (insomnia), posted by t2green01 on July 29, 2006, at 14:00:23
I had insomnia when starting Emsam 6mg, and again when going up to 9mg. For me, the insomnia went away but not the waking up many times during the night, daytime fatigue. I just got a script for klonopin today to address that.
From previous posts it seems that most people taking Emsam are also taking some kind of sleep aid. Also seems many were taking those aids prior to starting Emsam.
Good luck!
mayzee
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