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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by satsumas on February 23, 2008, at 10:24:01
Hi everyone,
Sorry for long post. Short version: I'm literally at my last rope and need any suggestions for other things to take with Emsam for insomnia.
I've long struggled with TRD and my dr. started me on Emsam 2.5 mos ago. I'm now at 12mg. While I feel it has had some positive effect (at least until the last few days when I spiraled into a terrible depression as a result of a bad life event) on my energy and mood, it has done nothing for anxiety (maybe made it worse) and nothing for my social phobia, which has crippled my life.
I am willing to keep on the Emsam because I feel like there is no other choice left. It's the first MAOI i've tried and I've been on probably 10 other meds the last few years, SSRI, stimulants, lamictal, etc. Probably BP2 or dysphoric or atypical or who the hell cares or knows at this point...all I know is that the terribly negative behavior patterns in my life haven't changed after 4 years of pharmacoptherapy and i'm at my last rope.
My particular question today is what to do about this terrible INSOMNIA that comes with Emsam. Thankfully I can fall asleep just fine, but wake up consistently 2-3 hours earlier, and as I'm sure some of you well know, it's not that the early morning awakening itself is so bad, its the particular thoughts that FLY through your head at 4am which are so distressing...to say nothing about the tiredness etc.
Dr. gave me Ambien CR which if anything feels like an alarm clock giving me exactly 5 hours of sleep. I used to be on trazodone 50mg which helped for sleep when i was on other meds, Dr. said this is an absolute NO-NO with Emsam. True or not? Other people on this board seem to be taking it with Emsam and its not giving them serotonin syndrome so..???
What else is there...Dr said when we raised the issue briefly last time that Ambien was the only bet...the other option would be to stop the Emsam. I feel like its the only thing thats even KINDA worked for me thus far so I just don't know what to do.
I'm so sick of this....!!!! I'm sick that I have to obsess about my mood and can't live life, I'm sick that I have to be on a 'crazyperson' board at 8.20am on a saturday alone in my bed because nothing has changed in my life in the past 4 years...and i'm sick of the loneliness and fear and self-sabotage and all the rest that comes with a broken brain. In my late 20s now and can't imagine living this way a minute longer...but what to do when 4 years of therapy and medicine haven't helped...what then????
Sorry to vent..been difficult few days.
Posted by Phillipa on February 23, 2008, at 11:46:32
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
Sorry you're having such a hard time. Some I think take klonopin and have done well wth it. Is it an option? Phillipa
Posted by Justherself54 on February 23, 2008, at 11:51:02
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
I am on Nardil which gives me terrible insomnia..I take zopiclone (which I'm sure is similar to Ambien), 05 of clonazapam and 50 mg of seroquel..increasing the seroquel finally allowed me to sleep straight through the nite..other than the occasion wakening (usually my dog moving around the bed or her snoring) but I'm able to get right back to sleep..
I know people get concerned about taking seroquel, but for me it's allowed me to stay on Nardil, which has turned me from a recluse to an extremely social person..
Maybe you could ask your doctor..if you're not getting sleep, the more likely you'll stop the Emsam, which could turn out to be the "one", as Nardil has been for me.
Posted by satsumas on February 23, 2008, at 14:48:56
In reply to Re: Emsam insomnia - DESPERATE for help! » satsumas, posted by Phillipa on February 23, 2008, at 11:46:32
i have never tried klonopin but im guessing my dr. wont be for giving me a benzo...plus i have concentration and motivation problems...not sure how that would affect me. last thing i need is to feel more withdrawed from the world and sluggish.
you know sometimes i think that at least the negative emotions, even if they are intense, are at least emotions and part of being alive. i just wish they didn't so often turn into obsessions, ruminations, and wear me out.
I know God gives everyone crosses to bear in life but he also offers hope and through faith, the strength to bear such crosses. But for how long and for what purpose....I pray and have not an answer yet....all the while it feels life goes on without me and my problems have yet to resolve themselves....the older i get the more i fear these troubles either hold me back from my peers or put me on a sidways path.
I know there are no easy answers to these questions that everyone with mood issues faces, but I struggle with putting too much expectation in medication, and then putting not enough. Sometimes I feel like just a drug seeker, looking for the next novel fix of something in my brain, rationalized by my "depression" not abating...then other times I get angry and jealous of these studies I read about some medication or the other (or some strange not intuitive combination) actually, finally, working for someone...and it changing their lives for the better.
I just dont know how long I can go on with hope that is never fulfilled.
Posted by d0pamine on February 23, 2008, at 16:46:52
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
After a couple years of use, I realized EMSAM is every bit as effective (if not more) when only used 12 hours / day instead of 24, and as an added benefit I started sleeping again after more than a year of only 2 to 3 hours of sleep / night.
Posted by Justherself54 on February 23, 2008, at 17:06:22
In reply to Re: Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 14:48:56
> i have never tried klonopin but im guessing my dr. wont be for giving me a benzo...plus i have concentration and motivation problems...not sure how that would affect me. last thing i need is to feel more withdrawed from the world and sluggish.
>
> you know sometimes i think that at least the negative emotions, even if they are intense, are at least emotions and part of being alive. i just wish they didn't so often turn into obsessions, ruminations, and wear me out.
>
> I know God gives everyone crosses to bear in life but he also offers hope and through faith, the strength to bear such crosses. But for how long and for what purpose....I pray and have not an answer yet....all the while it feels life goes on without me and my problems have yet to resolve themselves....the older i get the more i fear these troubles either hold me back from my peers or put me on a sidways path.
>
> I know there are no easy answers to these questions that everyone with mood issues faces, but I struggle with putting too much expectation in medication, and then putting not enough. Sometimes I feel like just a drug seeker, looking for the next novel fix of something in my brain, rationalized by my "depression" not abating...then other times I get angry and jealous of these studies I read about some medication or the other (or some strange not intuitive combination) actually, finally, working for someone...and it changing their lives for the better.
>
> I just dont know how long I can go on with hope that is never fulfilled.Don't give up..I know how frustrating it is trying to find the right med and what's it like to feel your brain chemicals have betrayed you..I hope you discuss with your doctor the insomnia problem..I have had to increase all my sleep meds to deal with the insomnia, but the payoff is relief..pure relief..from depression and isolation..hang in there..and you may have to get a little hard nosed with your doctor is he's not listening to you about the insomnia..it's no fun rolling around the bed all night watching the clock every hour!
>
Posted by satsumas on February 23, 2008, at 19:17:07
In reply to Re: Emsam insomnia - DESPERATE for help!, posted by d0pamine on February 23, 2008, at 16:46:52
> After a couple years of use, I realized EMSAM is every bit as effective (if not more) when only used 12 hours / day instead of 24, and as an added benefit I started sleeping again after more than a year of only 2 to 3 hours of sleep / night.
Really? I will try that...my doctor said that wouldnt make a difference last time I had an appt....i will try.
Posted by brooke484 on February 23, 2008, at 21:29:06
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
This came from The Wall Street Journal. From one of their health blogs.
"Finally, EMSAM will almost certainly induce insomnia if the patch is not removed prior to bedtime this is something that doctors do not explain to patients, and it is one of the primary reasons for discontinuation."
Posted by Racer on February 23, 2008, at 22:30:46
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
Ambien is hardly the only choice with EMSAM. While I was on EMSAM, I took Rozerem -- called it "the blue pony pill," because of the commercials which are very clever -- and found it worked very well for me.
Rozerem did not work right away -- it took a couple of weeks before it was consistently helpful, but once it was, it was the best I'd taken so far. It's also supposed to be helpful as an augmenting agent for depression.
Good luck.
Posted by Amigan on February 25, 2008, at 11:47:49
In reply to Emsam insomnia - DESPERATE for help!, posted by satsumas on February 23, 2008, at 10:24:01
I believe that this type of insomnia is caused by too much NE in your brain. 1-2 pills of Clonidine right before bedtime should fix this, but it may also worsen the depression.
This is the end of the thread.
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