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Dr. Bob is Robert Hsiung, MD,
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Posted by jealibeanz on November 5, 2006, at 20:54:39
In reply to Re: Trying Emsam. » corafree, posted by Phillipa on November 5, 2006, at 19:35:50
Oh jeez...
Posted by Phillipa on November 5, 2006, at 21:54:53
In reply to Re: Trying Emsam. » Phillipa, posted by jealibeanz on November 5, 2006, at 20:54:39
Sorry Jelly her computer sometimes won't let in e-mails. I also thought she might be at that EMSAM site she found. Did you see it. Is it in this EMSAM thread? I think it is and has some great reviews. Love Phillipa sorry about that
Posted by Phillipa on November 5, 2006, at 21:56:08
In reply to Re: Trying Emsam., posted by corafree on November 5, 2006, at 19:16:29
No it's another EMSAM thread. Love Phillipa
Posted by SLS on November 6, 2006, at 9:55:54
In reply to Re: Trying Emsam., posted by corafree on November 5, 2006, at 19:16:29
My doctor didn't think it would be justified for me to try Emsam again based upon my description of how badly I reacted to it. I am somewhat relieved not to have to subject myself to that again. I guess I will be left wondering what would have happened were I to have continued with it. Unfortunately, I have been down that road a few too many times where I have continued with a drug that had made me feel worse, agonizing without success. I just don't feel like putting myself through that right now.
- Scott
Posted by Crazy Horse on November 6, 2006, at 11:22:49
In reply to Re: Trying Emsam., posted by SLS on November 6, 2006, at 9:55:54
> My doctor didn't think it would be justified for me to try Emsam again based upon my description of how badly I reacted to it. I am somewhat relieved not to have to subject myself to that again. I guess I will be left wondering what would have happened were I to have continued with it. Unfortunately, I have been down that road a few too many times where I have continued with a drug that had made me feel worse, agonizing without success. I just don't feel like putting myself through that right now.
>
>
> - ScottUnderstandable.
-Monte
Posted by ed_uk on November 6, 2006, at 13:50:18
In reply to Re: Trying Emsam., posted by SLS on November 6, 2006, at 9:55:54
Hi Scott
What do you think you will try next? Tianeptine?
Ed
Posted by corafree on November 6, 2006, at 15:30:23
In reply to Re: Trying Emsam. » corafree, posted by Phillipa on November 5, 2006, at 19:35:50
Awakened w/ terrible cold. No kleenex so usin' TP, congestion, runny nose, sore throat. Should go to store and p/u daytime cold/allergy formula.
Feelin' a bit depressed re: ending relationship w/ IceCrea*Man. I know 'its right', but its damn lonely.
Pharm hasn't rec'd prior auth for Provigil yet, so awaiting call.
P agreed give the above a try @ visit Fri. Said take 75mg once or twice a day, whichever; & shouldn't take Valium down more than 5mg from 30mg per day, & keep Lyrica @ 75mg h.s.
I'm havin' such a hard time making decisions! What's the hel* is wrong w/ me .?. I used to know what I wanted/liked and vice-versa. Why can't I make up my mind about things?
Maybe Provigil will help me with this disoriented feeling.
Scott:
Worried U feelin' 'onstage' and 'afraid to let audience down' re: Emsam.
Do you need some 'breathing room' or is this thread (most rooting you forward) helping you?
I feel guilt at 'finding some sort of pleasure as you're taking my mind off myself' in sharing your personal experience w/ new pharmaceutical. (Sick borderline thinking.) The truth is, I want you to receive some much-deserved relief. I needed to share how I feel.
Phillipa:
So much going on and off. I do disappear 4 few days now and then, and you worry. (And, I love ya' for it!) You're always here when I need you. I don't know why, but sometimes I feel I need to 'just get away' from site, or I dive head first into IRL and it takes me a while to come back up for air! I'm here now tho'.
cf
Posted by corafree on November 6, 2006, at 15:51:47
In reply to Re: Trying Emsam., posted by Phillipa on November 5, 2006, at 21:56:08
> No it's another EMSAM thread. Love Phillipa
I'm confused P.
cf
Posted by SLS on November 6, 2006, at 17:39:37
In reply to Re: Trying Emsam. » SLS, posted by ed_uk on November 6, 2006, at 13:50:18
> Hi Scott
>
> What do you think you will try next? Tianeptine?
I've kind of settled on the idea of returning to Nardil and hoping that it might work this time in combination with nortriptyline and Topamax.I got hit with a wave of an intensification of depression today. I believe that this is a residual of the destabilization that Lyrica produced. It leaves me with some doubt as to whether or not the Emsam was responsible for the dysphoria and anxiety I experienced last week.
I am supposed to start Nardil on Wednesday.
I think I'll leave tianeptine for another time.
My spirit has faded.
- Scott
Posted by SLS on November 6, 2006, at 17:56:02
In reply to Re: Trying Emsam., posted by corafree on November 6, 2006, at 15:30:23
> Scott:
>
> Worried U feelin' 'onstage' and 'afraid to let audience down' re: Emsam.Sort of.
> Do you need some 'breathing room' or is this thread (most rooting you forward) helping you?I'm ok. I am conflicted, though. It is hard to be sure if I am making the right decision. I'm pretty sure I experienced a negative reaction to the Emsam, but without rechallenging myself with it, I can't be certain.
> I feel guilt at 'finding some sort of pleasure as you're taking my mind off myself' in sharing your personal experience w/ new pharmaceutical. (Sick borderline thinking.) The truth is, I want you to receive some much-deserved relief.Thanks. I appreciate it.
> I needed to share how I feel.
You are brave.
- Scott
Posted by Phillipa on November 6, 2006, at 18:05:10
In reply to Re: Trying Emsam. » corafree, posted by SLS on November 6, 2006, at 17:56:02
Scott I'm so sorry. And I know the feeling of not thinking you gave a med enough time. Does lyrica have some abnormal reaction for bipolar? No way you can know for sure if it was EMSAM or lyrica. I know you have a great pdoc and so much knowledge. Love Phillipa
Posted by KayeBaby on November 6, 2006, at 22:32:14
In reply to Re: Trying Emsam. » SLS, posted by Phillipa on November 6, 2006, at 18:05:10
Scott,
I am still taking the lyrica but when I have attempted to reduce the amount or increas the time between doses I felt awful. Depressed, negative thoughts and hopelessnes. Also a hungover ill feeling physically-headaches. Just ill.
just a fyi.
peace,
kaye
Posted by SLS on November 7, 2006, at 5:49:10
In reply to Re: Trying Emsam., posted by KayeBaby on November 6, 2006, at 22:32:14
> Scott,
> I am still taking the lyrica but when I have attempted to reduce the amount or increas the time between doses I felt awful. Depressed, negative thoughts and hopelessnes. Also a hungover ill feeling physically-headaches. Just ill.
> just a fyi.Hi Kaye
I'm sorry to hear that.
For you, I hope it is more of a short-lived rebound thing than the more extended destabilization thing that I think happened to me.
- Scott
Posted by ed_uk on November 7, 2006, at 14:01:25
In reply to Re: Trying Emsam. » KayeBaby, posted by SLS on November 7, 2006, at 5:49:10
Hi Scott
So has your doctor resolved his discomfort RE the phenelzine/nortriptyline combination?
Don't loose hope Scott. Hope is what keeps us going.
Take care
Ed
Posted by zeugma on November 7, 2006, at 17:32:46
In reply to Re: Trying Emsam. » KayeBaby, posted by SLS on November 7, 2006, at 5:49:10
hi scott.
i wish the emsam did what it is supposed to do- treat the anergia, anhedonia.
the usual prescriptions haven't worked. methylphenidate, modafinil, amphetamine.
Mirapex? It is supposed to be good for anhedonia.
I hope you can get started on the Nardil/nortrip combination soon.
-z
Posted by zeugma on November 7, 2006, at 18:57:22
In reply to Re: Trying Emsam. » SLS, posted by zeugma on November 7, 2006, at 17:32:46
i'm sorry the post above came out wrong.
i just was struck once by your comment that caffeine was more stimulating than amphetamine.
i wish i knew more about Ca2+.
-z
Posted by SLS on November 7, 2006, at 21:42:55
In reply to Re: Trying Emsam. » zeugma, posted by zeugma on November 7, 2006, at 18:57:22
> i'm sorry the post above came out wrong.
>
> i just was struck once by your comment that caffeine was more stimulating than amphetamine.
>
> i wish i knew more about Ca2+.
>
> -z
I am blessed that good people should take this kind of interest in me to remember such things.Thank you.
- Scott
Posted by KayeBaby on November 8, 2006, at 2:34:58
In reply to Re: Trying Emsam. » KayeBaby, posted by SLS on November 7, 2006, at 5:49:10
I have reduced the amount and suffered a bit then added some back and felt great for a couple of days then the body wants more!
Seems no sooner than I find a stable dosage for me my brain wants me to push up on the dose again. Higher dosages cause me to puff up and become slow and dull.
If I just tapered or went off of the Lyrica I would be in for a rough ride I can tell..
My brain latched on to this med before I even knew it was happening.I have a new naturalpathic doc who started me on buckets on vitamins, amino and also 2 grains of natural thyroid daily today.
I have my fingers crossed. Hope it helps with my listlessness and fatigue.
Anyone had any luck with thyroid meds? This my first trial.
What do you know Mr. Scott??
I just sent you a warm blanket of love to you on the psy vibe. Hope you can wrap up and stay warm tonight.
(note to self...no no no Ambien posts Miss Kaye-go to bed!)
Nite Y'all
Kaye
Posted by zeugma on November 8, 2006, at 17:19:59
In reply to Re: Trying Emsam. » zeugma, posted by SLS on November 7, 2006, at 21:42:55
>
>
> I am blessed that good people should take this kind of interest in me to remember such things.
>
> Thank you.you are so welcome.
i came across this on one of my periodic blocks, and thought you might be interested in this:
1: Eur Neuropsychopharmacol. 2006 Aug;16(6):451-8. Epub 2006 Feb 24. Links
Dual monoamine modulation for the antidepressant-like effect of lamotrigine in the modified forced swimming test.Consoni FT, Vital MA, Andreatini R.
Laboratorio de Fisiologia e Farmacologia do Sistema Nervoso Central, Departamento de Farmacologia, Setor de Ciencias Biologicas, Universidade Federal do Parana, Centro Politecnico, PO Box 19031, 81531-990, Curitiba, PR, Brazil.Lamotrigine is an anticonvulsant drug that exhibits a clinical antidepressant effect. However, few studies have been conducted with lamotrigine in animal models of depression and its mechanism of antidepressant action is still unclear. The present study evaluates the effect of lamotrigine (5-20mg/kg, i.p.) in the modified forced swimming test and compare its behavior pattern in the test with those of paroxetine (20mg/kg, i.p.), nortriptyline (20mg/kg, i.p.) and dizolcipine-MK-801 (0.1mg/kg, i.p.). The effect of lamotrigine on locomotor activity and memory was also studied in order to exclude false-positive results. At low doses, lamotrigine (10mg/kg) decreased immobility and increased climbing scores, a similar pattern to nortriptyline. A higher lamotrigine dose (20mg/kg) also increased swimming scores. Lamotrigine neither changed locomotion in the open-field test nor impaired habituation. Paroxetine and dizolcipine decreased immobility and increased swimming. Dizolcipine also decreased climbing. However, although the effects of paroxetine and nortriptyline were seen without effect on locomotor activity, dizolcipine increased locomotor activity. The present study indicates that the antidepressant-like effect of lamotrigine is probably related to noradrenergic/serotonergic systems.
-z
>
>
> - Scott
Posted by SLS on November 9, 2006, at 9:08:14
In reply to Re: Trying Emsam. » SLS, posted by zeugma on November 8, 2006, at 17:19:59
I spoke to my doctor yesterday, and I told him that I was still being thrown around by some residual instability, apparently produced by my exposure to Lyrica. It comes in waves. I told him that I was now unsure as to whether the worsening I experienced last week was due to the Emsam or the result of the residual Lyrica-induced instability.
I don't think now is the right time for me to commit to a course of treatment with Emsam. I doubt I would persist with it were I to continue to experience this exacerbation and instability. I was already biased against the drug before I started taking it the first time. For now, I think I would rather go with Nardil, and hope that it produces an improvement when taken in combination with nortriptyline. I really don't know if I'm doing the right thing. I guess I'm being driven by the desire to experience some relief.
- Scott
Posted by Shay Sweet on November 9, 2006, at 14:58:27
In reply to Re: Trying Emsam. » SLS, posted by ed_uk on November 4, 2006, at 14:35:57
--------------------------------------------------------------------------------
Having been on both sides of the fence--that is to say I've worked both for community mental health/private pay residential and have taken medication for depression--I have so many thoughts, concerns and horror stories lingering in my brain that it is difficult to encourage people to seek treatment.That said, I also have a couple of "acquaintances" who work for Pfizer and other well=known Pharmaceutical companies as "drug reps." I have made these contacts through various employment related conferences, luncheons, etc.
Of the two different types of settings for mental health/substance abuse, the private pay facility was by far more corrupt than that which received government grants. This is likely due to all of the hoops you have to jump through in terms of paperwork, auditing, etc. in exchange for the grant money. It is a much safer environment in my opinion simply because it is regulated.
I found it a bit odd that the private facility (both of whose names I will withhold) was not saturated with the wealth of accoutrements such as pens, sticky notes, staplers and calendars with names like Campral, Risperadol, Cymbalta, Lexapro, Zoloft and even the newest form of Alprazolam (Xanax) manufactured by Schwarz/Pharma, called Niravam, which are orally disintegrating tablets for those who cannot be bothered with water when a panic attack strikes. Their brochure, which brags the drugs ability to "Wind Down Anxiety," includes a quiz for one to self-determine the presence of possibly GAD--or Generalized Anxiety Disorder--and several asides with quips like, "Symptoms often date back to childhood..." in the margins.
The marketing of 'new' drugs, with the same active ingredient but directed toward a different category of people, is despicable. For example, how many of you remember the drug Sarafem? Boasting its ability to treat PMDD, or Premenstrual Dysphoric Disorder, the active ingredient Fluoxitine is the exact replica of the antidepressant Prozac. The overtly feminine marketing done by Wyeth, or whichever company it was, was supposed to account for the drugs huge price boost (nearly triple the cost of Prozac).
I don't want to bore anyone by going on and on, so I'll just mention one more thing here; the previous poster who spoke about drug companies being held accountable for being deceptive is absolutely correct.
In fact, at a recent luncheon I attended (fabulously catered, I might add), Bristol Myers Squibb's Medical Science Liaison (former pharmacist made her a delightful new twist to the usual rep who is less credible due to lack of medical experience) gave what must have been her first presentation for the company's new drug, EMSAM. She was a young, cute Vietnamese girl whose mispronunciations of medical terms only had the Psychiatrists giggling flirtatiously as they blotted their mouths with napkins to catch lingering remnants of turkey-avocado rollups.
This drug is an MAOI (monoamine oxidase inhibitor for those who don't know much about them accept for the fact that it seems as if most other drugs are contra-indicated with an MAOI according to the literature accompanying the drug and the commercials that follow.
I did learn a lot from this conference, such as the reasons for not taking MAOI’s, which has something to do with the limitations of certain foods from one’s diet containing tyramine, which is found in red wine, certain meats and very potently in cheese, especially the really strong, smelly cheeses. The combination causes hypertensive crisis/blood pressure surges. However, the marketing strategy here is the introduction of EMSAM, which is ingested a different way, therefore bypassing the stomach and eliminating the risk. Look it up on the web for more in-depth info.
The point I was going to make before I trailed off was that this girl was so naïve, she actually answered the doctor’s question about “off label use,” which is highly punishable and under investigation right now with drug companies nationwide, flippantly, with a wink-wink sort of move. The girls seated on the sidelines, who were more experienced reps, winced at the suggestion/gesture of their coworker. No one else seemed to notice.
Sorry for the long post folks! I’m unemployed, and yet somehow I find the time for this inane blathering. Oh well. Maybe it will help someone.
_________________
Respectfully,
Shay"If we were our bodies, If we were our nametags
If we were our rejections
I'd be joining you."
Posted by Shay Sweet on November 9, 2006, at 15:09:28
In reply to Re: Trying Emsam. » SLS, posted by Phillipa on November 6, 2006, at 18:05:10
> Scott I'm so sorry. And I know the feeling of not thinking you gave a med enough time. Does lyrica have some abnormal reaction for bipolar? No way you can know for sure if it was EMSAM or lyrica. I know you have a great pdoc and so much knowledge. Love Phillipa
SCOTT:
I did not read your entire post nor the entire thread, so forgive the insensitive nature of my previous post please.
I have the notes from the seminar I attended, and I just noticed above that you are Bipolar? The literature from the manufacturer states:
"EMSAM is indicated for the treatment of Major Depressive Disorder (MDD)...RISK OF BIPOLAR DISORDER should be ruled out prior to initiating antidepressant therapy. EMSAM is not approved for the treatment of bipolar depression."I just thought I should alert you so you can notify your doctor! Please feel free to ask me anything; if I can get you a copy of this literature somehow, I would be happy to do it.
Respectfully,
Shay
Posted by Phillipa on November 9, 2006, at 17:30:29
In reply to SCOTT--alert!, posted by Shay Sweet on November 9, 2006, at 15:09:28
Can it be e-mailed? As my babblemail light is on. And if you babble me I will give you my e-mail and make sure it gets to Scott. So what do they say about TRD being a bipolar disorder now? And have a med trigger a manic episode for the first time. And the new categories of bipolar. No more high, low, normal. Love Phillipa so how can they rule bipolar out with the new categories?
Posted by SLS on November 10, 2006, at 8:32:54
In reply to SCOTT--alert!, posted by Shay Sweet on November 9, 2006, at 15:09:28
Hi.
Thanks for the thoughtful warning.
Yes. I do risk a switch into mania, but that would be a welcome event. It has happened on rare occasion in association with an MAOI. However, it seems to be quickly controlled with either Depakote or Zyprexa. Hopefully, the Abilify that I am currently taking will prevent it from happening.
I started taking Nardil yesterday.
Currently:
nortriptyline 100mg
Nardil 15mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by ed_uk on November 10, 2006, at 15:11:47
In reply to Re: SCOTT--alert! » Shay Sweet, posted by SLS on November 10, 2006, at 8:32:54
Hi Scott
Glad to hear you've started the Nardil already. I was wondering, would it be best to stop the Topamax? Given the risk of side effects (eg. kidney stones), is it worth continuing with it?
Ed
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