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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Enigma on April 29, 2006, at 12:30:28
Well, Emsam day 10, 6mg dose and it's still making my life hell. There's no other way to put it.
I feel little to NO AD effects, and only a massive fatigue/lethargy/no energy side-effect. 2 days prior to starting it, I had some pretty bad fatigue, and was on 0 meds at the time. I then started Emsam and I've been 100% useless as a human being. Tired each and every day, ALL DAY. Too tired to do anything, even play video games. The fatigue comes in waves, where it's minimal to major, major meaning, I get so tired I am forced to take a nap.
Sleep of any kind, be it overnight or a nap is completely *unrefreshing*. Sleeping pills and other sleep aids I've tried aren't helping at all. I can't get out of bed unless I've had 12 hours of sleep, and even then, I'm exhausted when I get up.
The depression is always worse when I'm lying in bed, for some odd reason.I have no choice but to believe all? of this is being caused by the Emsam, even though this isn't a major or even a minor listed side-effect. I stopped Emsam twice, only for < 1 day, and it seemed like the fatigue was lifting.
Lexapro and Effexor have done something similar to me, but they also caused me other problems like dizzyness, nausea, etc.
How long should continue this nightmare? My doctor is clueless, and that's being NICE. I have no idea who else to ask. Can I email Bristol Myers?
Nardil is about the only drug out of about 30 that did anything for my depression, and even then caused me serious side-effects. Parnate was intolerable (due to side-effects).
Like some others here, I've found myself to be fairly untreatable (for atypical severe depression) and don't have the any strength left to keep fighting. One can only lose so many times while keeping the will to fight, at least for me.
I've tried too many therapists, too many doctors, too many meds, too many suppliments/vitamins/wallet vacuums, even ECT. The most I've ever seen is *some* temporary relief, and that's it.
What's left to try? I'm sick and tired (no pun intended) of being a walking prescription drug lab test. Lab rats have it better than I do!
Anyway, main question again.. How long to continue Emsam? The depression isn't any better, and I can barely function being this tired. This was supposed to be my miracle drug too.. looks like that was a pipe dream.
Posted by linkadge on April 29, 2006, at 20:47:51
In reply to EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on April 29, 2006, at 12:30:28
You could try adding the DLPEA to the EMSAM. That might be too stimulating though.
Linkadge
Posted by Phillipa on April 29, 2006, at 23:29:42
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by linkadge on April 29, 2006, at 20:47:51
Since I always expenience anxiety on meds that tire others out maybe ENSAM will do the opposite. Love Phillipa
Posted by ravenstorm on April 30, 2006, at 9:33:48
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Phillipa on April 29, 2006, at 23:29:42
I replied to your previous thread about this, but perhaps you missed it.
When I started on Wellbutrin, it made me so tired I could barely walk for AT LEAST two weeks, my pdoc couldn't believe it. After the first two to three weeks, however, it became activating, and unfortunately, shortly after that it became way too overactivating and I had to stop taking it.
Only you can make the decision. But why throw away a drug trial when this could clear. I would wait at least four weeks.
I did the four week starter pack of serzone once (I believe it takes four weeks) and was pretty much in a coma the whole time so I know how you feel. I'm glad I did the whole trial, though, because now I never have to wonder, what if?
Posted by Enigma on April 30, 2006, at 12:38:33
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by ravenstorm on April 30, 2006, at 9:33:48
Thanks for the response (all of you).
I did read your other email, but forgot about it... My memory isn't what it used to be, plus ECT and this fatigue are definately causing me memory problems too.
I've had so many bad experiences, that it's hard to have any "hope" that the side-effects (if that what this truly is) will go away. I've only ever experiences a very small number of side-effects that have ever gone away over time. One example would my dry-mouth from Wellbutrin. Had it for a few weeks? then it stopped completely. Can't think of many other examples.. that might have been the only one to actually go away.
I need to find a new PCP (cause I want to punch mine - long story), and get a full workup.
Prior to the Emsam, I had the worst sinus infection I've ever had. I was on no psych meds at the time. This illness lasted 6 weeks, and I took 3 different anti-biotics to help clear it. Problem is, I'm not 100% sure that it's gone.
Because so few (no one?) seems to be getting fatigue from Emsam, I'm really wondering if something else is going on. I keep checking the Emsam side-effect lists and package content docs to see if I'm missing something. I never find anything about fatigue on there.
Currently, I still feel slight sensitivity when touching my sinus areas on my face, and I'm still getting headaches, but not nearly as bad as before.
I sweat like crazy from doing even the smallest activity, and I don't smoke, nor am I overweight. (168 pounds, 5'9", male). I know many AD's can screw with your body's ability to regulate its temperature, but this increased sweating continued even after I stopped Wellbutrin and many other drugs that listed this side-effect. This sweating problem started with the AD's. I never had anything like that before.
Anyway, I took the patch off yesterday, and I seemed to regain some energy soon afterwords. That's 3 times that I stopped the Emsam for about 24 hours, and each time felt more awake (but still tired) after doing so. This can't be a conincidence.
I felt far from great, but was able to climb a tree and cut some dead branches down, and get some painting done in the garage. It's been a week since I've been able to get anything done around the house.
Anyway, as far as the sweating, it's getting really obnoxious. I sweat whenever I take a shower (afterwards), or drink hot liquids. So much so, that I sometimes have to change my clothes!.. Just drank a coffee after my shower, and I had to take my shirt off, and now need a new one.
I dunno. I really wish I could find a doctor, any doctor of any kind, that actually *wants* to help me get better, and is willing to work at it until I've reached some level or normality. I'm simply in shock at how impossible of a task this has been for me. Only one doctor in the last 15 years has ever cared about me and his other patients, then he goes into early retirement. :( He's the only one I've ever respected.
Now I have to decide if I want to put the patch back on today.
Posted by Enigma on April 30, 2006, at 12:41:21
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by linkadge on April 29, 2006, at 20:47:51
> You could try adding the DLPEA to the EMSAM. That might be too stimulating though.
>
> LinkadgeWhat is DLPEA again?
Posted by ravenstorm on April 30, 2006, at 16:47:51
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on April 30, 2006, at 12:38:33
I hear you about docs. In the past 15 years I've also only one competent one and he retired some time ago.
WB also didn't have anything listed about fatigue, but that was my reaction to it the first couple of weeks. Wonder if its some weird reaction to dopamine? I have a paradoxical reaction to benzos as well. But as I state earlier the fatigue on Wb did eventually pass.
Good luck. I know it sucks right now.
Posted by Enigma on May 1, 2006, at 11:26:23
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by ravenstorm on April 30, 2006, at 16:47:51
(skip to end for Emsam update)
Good, in a way... that someone has had the same problem with doctors. I mean really, how hard can it be to be a good p-doc? It requires 0 effort to be a bad one, but they don't seem to ever get fired or reprimanded.
I'm a software engineer, and man, I really gotta stay on top of things at work, always learning new things, technologies, etc, just to keep up. (On disability now though)
To be a p-doc? You just gotta show up to work, listen to every 5th word a patient says, write some scripts, and bam!, you're employed, and making a ton of money to boot. Med school must have been the only difficult part in their entire career. I wish I could have tolerated college longer, and didn't need to get out and work asap, so I could have stayed for my phd too. Don't get me wrong though, I would have actually TRIED to help people, NOT do what my doctors pretend to do.
You could replace many of my doctors with manaquins and a tape recorder and they would functionally equivalent.
Sad.
Anyway, if you got this far...
Emsam update:
I put the patch back on after removing it for 24 hours, and the rest of that day, didn't get tired. I was SHOCKED. I actually jumped on the exercise bike for 25 mins or so. First time I've done that in a YEAR.
I'm tired today, but not severely tired like previous days. I got away with only 9 hours sleep, not my usual 12+.
The only thing I changed was that I started drinking "Noni" juice a few days ago. I saw some health show on cable (probably a fake show, real infomercial) that said Noni juice is highly recommended for peeps with Chronic Fatigue.
Either the juice is working (tastes nasty though), or I'm getting used to the Emsam, or maybe the 24 off of it really helped.. I wish I knew. Could be 1, 2, or all three of those.
Anyway, I hope this is a turning point, and not just a temporary thing. I'm still kinda depressed though, and only found Emsam to be helping a little (if at all) in that dept. Wednesday (3rd) will be 2 weeks on Emsam, minus the 3 random days I stopped it for a day (cause I couldn't stand the fatigue). Hopefully the MAOI effects will kick in soon.
Posted by ravenstorm on May 1, 2006, at 12:03:36
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on May 1, 2006, at 11:26:23
You crack me up! Yeah, I think pdocs have to be the laziest professionals in the world. But again, I've had really bad ones, so I am completely biased.
I actually have heard of Noni juice and had it recommended to me, but my stomach couldn't handle that either. Maybe I'll try it again later this summer.
Glad you may be doing better. Keeping my fingers crossed for you!!
Posted by Declan on May 1, 2006, at 18:24:41
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on May 1, 2006, at 11:26:23
It's interesting you mention the Noni Juice. I have used it at times, some of them VERY stressful, and I was as sure as I could be (I think) that there was some seratogenic(is that a word?) effect if I took enough. Could the Noni have helped balance the Emsam?
Declan
Posted by stowe on May 1, 2006, at 19:04:25
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Declan on May 1, 2006, at 18:24:41
enigma,
Sounds like your body may have been depleted by the infection and all the antibiotics. The combo of infection and 3 different antibiotics can cause loads of fatigue. I have been struggling with fatigue as a MAJOR symptom of my depression for a few years. And now I realize that having been on antibiotics on and off for various infections led to yeast problems, etc. for which fatigue is a major problem. Long and short of it: you might want to try taking acidophilus tablets to replenish your system with "good bacteria." having said all that: I AM SO GLAD TO HEAR YOU ARE FEELING BETTER! oh yeah , and by the way, almost every pdoc I have seen has been a real you know what.... I finally have an amazing nurse-psychiatrist who really listens and gets it.best of luck!
gigi
Posted by Dr. Bob on May 1, 2006, at 19:51:21
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Declan on May 1, 2006, at 18:24:41
> It's interesting you mention the Noni Juice...
Sorry to interrupt, but I'd like to redirect follow-ups regarding Noni Juice to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20060428/msgs/638978.html
Thanks,
Bob
Posted by scatterbrained on May 1, 2006, at 22:27:29
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on April 30, 2006, at 12:38:33
If you are feeling malaise maybe a physical check up might be something to look into. If you go get checked out by an internist and nothing is wrong then at least you are being systematic about it all.At least you know where it is coming from.
I wouldn't stop the ensam prematurely without knowing for sure if it's causing the fatigue. And even if it is it still would be premature to stop it because the side effect might go away(maybe give yourself a timeframe of a month).
Posted by Donna Louise on May 4, 2006, at 6:40:28
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on May 1, 2006, at 11:26:23
"You could replace many of my doctors with manaquins and a tape recorder and they would functionally equivalent."
I figure when you still have such a good sense of humor, you are doing ok somewhere in your soul. You gave me a good laugh for which I am always grateful.
I have not had fatigue, I am more like Robert David and getting less sleep because I am not fatigued and sleeping most of the day and night as I was. I have just been really scatterbrained and have HAD TO get whatever done before I go to bed so it has been like 1:00or 2:00 AM. The latest I can stay in is 7:00 AM because my horses and dogs make their needs known. But now I stay up and don't feel tired for the lack of it. I like others, bet you are still worn out from your other conditions and it is taxing to introduce a new drug and you will get over it and keep feeling better. There, I needed to hear me say that as I am still having effexor withdrawals that have about put me 6ft under, new ones popping up still after two weeks. It is like I got old overnight. I KNOW this too shall pass. So much better I can see through this with the patch on. Now I need to start a new thread about the dang thing coming off.Donna
Posted by sparc5 on March 5, 2008, at 6:23:13
In reply to Re: EMSAM and *unbearable* fatigue, continue it?? » Enigma, posted by Donna Louise on May 4, 2006, at 6:40:28
I had the same exact fatigue problem with Emsam. My depression has always made me tired, but it about quadruples with Emsam. I think this effect happens in men more then women. For women, I would expect the opposite, it would be cool to get some anecdotal evidence.
What is odd is when I started Emsam it gave me energy and I could hardly sleep 6 full hours. After 1 month at 12mg I went to 30mg in hopes it would do more then just take away my moderate fatigue, but sadly, I got no benefits and the fatigue was unbearable even after going back to 12 for 2 more moths. It seems my brain never returns to it's pre-emsam therapy state. Drinking a lot of caffeine (6 cups of coffee a day) got rid of half the fatigue, a tolerance did develop to it, but half a week of no caffeine got rid of the tolerance.
I went back to Effexor (75mg) after being off it for many months and for the first time in months I didn't feel tired. It was a great feeling, but the side effects reluctantly makes me rather not take anything.
Now the doc suggested neurontin...
Posted by Enigma on March 5, 2008, at 7:39:31
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by sparc5 on March 5, 2008, at 6:23:13
Thanks for the response, but you're 2 years too late. :)
Man, it's been a long time since I posted here.
I've tried many drug combo's since Emsam.Emsam gave me horrible application site reactions (rashes where the patch was - like poison ivy) so I could not continue it anyway.
I just got off to Selegiline in pill format because it wasn't doing enough for the depression, even at max dosage. I'm on Vivactil for an AD now, and still upping the dosage, Seroquel to help me sleep, and Abilify for manic symptoms (in my case, in controls irritability fairly well.
I'm still not back working again. :(
Posted by sparc5 on March 5, 2008, at 7:59:41
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on March 5, 2008, at 7:39:31
Did the Selegiline in pill form do anything Emsam couldn't except no rash (and no MAOI foods)?
I tried one other MAOI last week. I made it myself by boiling crushed Syrian Rue seeds in Lemon Juice then drinking the tea, or evaporating it and ingesting the powder. It's cheap and very effective, too high of a dose and you get a stomach ache and your limbs feel weightless.
Posted by Enigma on March 5, 2008, at 15:13:10
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by sparc5 on March 5, 2008, at 7:59:41
> Did the Selegiline in pill form do anything Emsam couldn't except no rash (and no MAOI foods)?
>
> I tried one other MAOI last week. I made it myself by boiling crushed Syrian Rue seeds in Lemon Juice then drinking the tea, or evaporating it and ingesting the powder. It's cheap and very effective, too high of a dose and you get a stomach ache and your limbs feel weightless.Well, in pill form, I didn't have any fatigue.. I think that's about the only difference, minus the rash and such like you already said.
I didn't know you could make your own MAOI... funky. Sounds scary as it seems like you wouldn't have a clue about the dosage though, creating it like you did.
Syrian Rue seeds.. interesting...
Posted by sparc5 on March 6, 2008, at 16:45:01
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by Enigma on March 5, 2008, at 15:13:10
> > Did the Selegiline in pill form do anything Emsam couldn't except no rash (and no MAOI foods)?
> >
> > I tried one other MAOI last week. I made it myself by boiling crushed Syrian Rue seeds in Lemon Juice then drinking the tea, or evaporating it and ingesting the powder. It's cheap and very effective, too high of a dose and you get a stomach ache and your limbs feel weightless.
>
> Well, in pill form, I didn't have any fatigue.. I think that's about the only difference, minus the rash and such like you already said.
>
> I didn't know you could make your own MAOI... funky. Sounds scary as it seems like you wouldn't have a clue about the dosage though, creating it like you did.
> Syrian Rue seeds.. interesting...
>Did you stick strictly to the MAOI diet on Selegiline in pill form? I wonder why the patch makes you tired but the pill doesn't. Very interesting.
There are a few plants with MAOI's you can extract from it. Syrian Rue you can grow yourself. The downside to it is there is no time release technology, you can feel it after 20 minutes, then it slowly tapers off in 4-6 hours. Getting the dose right is another serious problem. It's usefulness as an antidepressant / antianxiety medicine is greater then any pills I've tried.
Posted by Enigma on March 6, 2008, at 17:54:39
In reply to Re: EMSAM and *unbearable* fatigue, continue it??, posted by sparc5 on March 6, 2008, at 16:45:01
>
> Did you stick strictly to the MAOI diet on Selegiline in pill form? I wonder why the patch makes you tired but the pill doesn't. Very interesting.
>
> There are a few plants with MAOI's you can extract from it. Syrian Rue you can grow yourself. The downside to it is there is no time release technology, you can feel it after 20 minutes, then it slowly tapers off in 4-6 hours. Getting the dose right is another serious problem. It's usefulness as an antidepressant / antianxiety medicine is greater then any pills I've tried.I know I wrote the original message about Emsam and fatigue, but I honestly can't remember it causing me fatigue. I remember it working "ok" as an AD, except for the awful rashes. I could have had fatigue just from the depression, I don't know, I wrote the original post 2 years ago. ;)
To answer your question though, I did stick to the MAOI diet with the patch, and the pills.
Interesting about the plant. I'll stick to the pharmaceuticals myself. I can't imagine growing my own meds. ;) I'd probably screw up the dosage.
I just switched to a TCA and Abilify to control the severe irritability I would get when using the TCA by itself (it causes some manic reaction in me). I can't seem to get to sleep normally, so I also take Seroquel at night. If things improve just a little, and *stay that way* for a few weeks at least, I might be headed back to the job market. I've been out of work for 3 years now. Pretty sad.
This is the end of the thread.
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