![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by pulse on May 13, 2006, at 14:13:26
Hi All,
I'm back for now to ask the above question, because it *may* be (ODDLY!) that Emsam at night relieves the relentless anxiety and teeth-clenching for me.
(There is MUCH more involved with my Emsam experience/S, but I'll post that ASAP, as it's quite lengthy).
One read-out or article I saw, said you can put the patch on anytime during the 24 hr. period.
Please, everyone (regardless), post when YOU are putting on the patch.
TIA,
pulse
Posted by lymom3 on May 13, 2006, at 21:11:30
In reply to Anyone Apply Emsam at night?, posted by pulse on May 13, 2006, at 14:13:26
I do it in the morning just because that's when I shower. I found out quickly that you really do need to thoroughly wash the area that you are going to apply the patch too. I also take medication in the morning so it's just a routine.
I don't notice a little tingle when I put the new patch on everyday...maybe it might make a difference applying it at night??
Posted by pulse on May 14, 2006, at 13:00:13
In reply to Re: Anyone Apply Emsam at night?, posted by lymom3 on May 13, 2006, at 21:11:30
Thanks so much for weighing in!
I sure hope LOTS of others will see this and tell me when THEY apply Emsam.
best regards,
pulse
Posted by RobertDavid on May 14, 2006, at 18:24:10
In reply to Re: Anyone Apply Emsam at night? » lymom3, posted by pulse on May 14, 2006, at 13:00:13
I put the patch on every morning after I shower. I never gave any thought to putting it on at night. It would be interesting to hear from those that have switched to patching at night. Rob
Posted by pulse on May 14, 2006, at 19:51:40
In reply to Re: Anyone Apply Emsam at night?, posted by RobertDavid on May 14, 2006, at 18:24:10
Yes, Robert, indeed that WOULD be interesting...IF anyone other than me has attempted it, noticed a *possible* better reaction as I *may* have had (??), AND they have, then, continued taking it at night.
So far, the night thing is just one of my (now 4 in 1 month *on*, OR simply HAVING to be OFF the patch, and I'm a REAL trooper, BTW) experiments re: how I can possibly manage to handle Emsam, as it quite literally IS my last chance. (NO other ADs or combos are tolerable anymore due to GI; ECT doc/s retired)
Emsam has been highly unpredictable for me, and for the most part quite unpleasant, with anxiety increasing, a small bit of help ONLY for MDD, NOT to mention horrid constipation/ lower GI major upsets, requiring that I now have to - every 3rd day - increase to a full dosage of zelnorm, another expensive AND unpredictable drug, rather than the half dosage I've always gotten by with, when I've succumbed to taking zelnorm, yet again.
Also, ravenstorm, there is *some* nausea. I have dreaded having to tell you any of this GI stuff!
I realize my experiences with Emsam should be on the side-effects thread, but I'm just not up to explaining in any more depth at this time. Sorry all.
pulse
Posted by RobertDavid on May 14, 2006, at 21:22:44
In reply to Re: Emsam at night?ravenstorm sorry GI problems, posted by pulse on May 14, 2006, at 19:51:40
The only experiment I have done was on a 2 occations taking the patch off at bedtime, then back on in the morning.
I have always had insomnia, I just can't buy a good nights sleep. After talking with my doctor about various possible meds to try for insomnia he suggested taking the patch off at night. He said he thought perhaps the activation, energy and mood elevation I get during the day would remain and I might sleep better at night.
The theary being that since I have more energy during the day than prior to taking EMSAM (which is allowing me to be more active, go to the gym more, etc.) I should be more tired at night and that by taking the patch off I'd reduce the selegine activation and sleep better. Then by putting the patch back on in the morning I'd get be right back where I was before, feeling good. He felt my blood levels would still remain high enough for it to continue working for me.
Since I've done so well on it I didn't really want to mess with this, but on the 2 times I've tried it, it worked. I slept good felt even more energy than before (probably because I slept better than ever).
So I think I'm going to give it a try for a week and see what happens. It would sure be great if this was the trick to not only treat my anxiety and depression, but get rid of a lifetime of insomnia as well. If it doesn't pan out I'll go back to wearing it 24/7. I'll post how I do.
Posted by Donna Louise on May 15, 2006, at 8:13:01
In reply to Anyone Apply Emsam at night?, posted by pulse on May 13, 2006, at 14:13:26
> Hi All,
>
> I'm back for now to ask the above question, because it *may* be (ODDLY!) that Emsam at night relieves the relentless anxiety and teeth-clenching for me.
>
> (There is MUCH more involved with my Emsam experience/S, but I'll post that ASAP, as it's quite lengthy).
>
> One read-out or article I saw, said you can put the patch on anytime during the 24 hr. period.
>
> Please, everyone (regardless), post when YOU are putting on the patch.
>
> TIA,
> pulse
>I put it on at night because I am a nighttime showerer. (I hate water to touch me in the morning) So I peel the old one off in the shower and then put the new one on when I get out. That way it sticks. I was putting it on in the morning and it wouldn't stick so I think for me it has to go on right after I get out of the shower and there is no way I will be taking a shower in the morning. I too have had zero teeth clenching that lexapro for example caused me to have like 5 crowns and a root canal from all the bruxism, all the sri's did that to me to some degree or other. But no facial, jaw, scalp tension, or shoulder tension for that matter at all for me on this patch. I just now realized how absent all that is as I am typing this. Thanks for asking that question!
Donna
Posted by pulse on May 15, 2006, at 12:42:58
In reply to Re: Emsam at night?ravenstorm sorry GI problems, posted by RobertDavid on May 14, 2006, at 21:22:44
Thank you for all this, especially that you'll post the results if you do the night-time applying of Emsam.
Best Regards,
pulse
Posted by pulse on May 15, 2006, at 13:06:36
In reply to Re: Anyone Apply Emsam at night? » pulse, posted by Donna Louise on May 15, 2006, at 8:13:01
On the contrary, I've had so much teeth-clenching with Emsam at anywhere above (get this!) 2 HOURS (3 hrs. TOPS) a day ON at ONE "setting", that I've already broken off a large piece of one of my back teeth.
I'll just continue my side-effects on this thread, now that it has "got going." The gist of all this is, my most "successful" experiment (the latest one) has been:
ON 2 hours, then off; then, I HAVE to go SEVERAL hours, then on 2 hrs. again; then off. A few times , I've managed this 3 times a day. This would cost me, doing it this way, $1,280+ / month, IF my doc would ever even approve it! Mostly all due to GI problems - even back on the dreaded zelnorm for ibs-c/ chronic constipation (I have both) Emsam still shuts my lower GI almost completely DOWN + I find it VERY drying in multiple areas and organs of my body. I forgot to mention extreme urinary retension. I have a good guess, that for me, this drying started up with somewhat early meno at 46; I'm now 54.
Thank you for stating that you DO put it on at night.
(BTW, boy oh boy, can I relate to the any water touching me in the AM!)
pulse
Posted by RobertDavid on May 15, 2006, at 13:36:05
In reply to Re: Anyone Apply Emsam at night? » Donna Louise, posted by pulse on May 15, 2006, at 13:06:36
> On the contrary, I've had so much teeth-clenching with Emsam at anywhere above (get this!) 2 HOURS (3 hrs. TOPS) a day ON at ONE "setting", that I've already broken off a large piece of one of my back teeth.
Are you saying you're taking the patch off every few hours? And if so you're putting a new patch on?
Rob
Posted by pulse on May 15, 2006, at 15:22:39
In reply to Re: Anyone Apply Emsam at night? » pulse, posted by RobertDavid on May 15, 2006, at 13:36:05
Thats' EXACTLY what I'm saying. I've had NO choice, as my 2 above side-effects related posts documented all the many - unbelievable!!! - problems I've encountered.
Just spoke to my pharmacist, whom I trust WAY more than my doc, and he said that Somerset should never have PROMISED me there would be no GI problems, as Emsam, even if it goes only through the bloodstream, still could, and, obviously DOES, cause GI problems - at least in those prone to them. Again, I have absolutley NO organic GI problems. (IBS is always stress-related: depression or anxiety or both.) My GI problems were & are psych-med caused. I likely have - at times ONLY - some somatic GI problems, but do not have somatoform disorder, just for the record.
My pharmacist just faxed alot of this info to my doc. The pharmacist will get back to me tonite or in AM.
On another note, what is a real mystery to me is this: seems like, although, most all - if not all - studies re: Emsam were for major depressive disorder (my far & away main dx), most HERE doing the best are the social anxiety (and a few GAD) folks, at least as their primary dx/es. I just don't get it!
pulse
Posted by pulse on May 15, 2006, at 15:33:15
In reply to Re: Anyone Apply Emsam at night? » RobertDavid, posted by pulse on May 15, 2006, at 15:22:39
Forgot to add the importance of Somerset AND BMS now putting this GI problems info out, rather than saying ONLY in their lengthy package insert, "more side-effects may be possible" or some such minimization.
This needs to be documented by them for further studies, etc, AND re: the public's right to know/ safety concerns.
Posted by cecilia on May 15, 2006, at 18:01:40
In reply to Anyone Apply Emsam at night?, posted by pulse on May 13, 2006, at 14:13:26
In theory at least it should make no difference when you apply it, the whole point is even distribution throughout 24 hours. Real life, of course, does not always correlate with theory. Cecilia
Posted by RobertDavid on May 15, 2006, at 21:12:17
In reply to Re: Anyone Apply Emsam at night? » RobertDavid, posted by pulse on May 15, 2006, at 15:22:39
> Thats' EXACTLY what I'm saying. I've had NO choice, as my 2 above side-effects related posts documented all the many - unbelievable!!! - problems I've encountered.
>
> Just spoke to my pharmacist, whom I trust WAY more than my doc, and he said that Somerset should never have PROMISED me there would be no GI problems, as Emsam, even if it goes only through the bloodstream, still could, and, obviously DOES, cause GI problems - at least in those prone to them. Again, I have absolutley NO organic GI problems. (IBS is always stress-related: depression or anxiety or both.) My GI problems were & are psych-med caused. I likely have - at times ONLY - some somatic GI problems, but do not have somatoform disorder, just for the record.
>
> My pharmacist just faxed alot of this info to my doc. The pharmacist will get back to me tonite or in AM.
>
> On another note, what is a real mystery to me is this: seems like, although, most all - if not all - studies re: Emsam were for major depressive disorder (my far & away main dx), most HERE doing the best are the social anxiety (and a few GAD) folks, at least as their primary dx/es. I just don't get it!
>
> pulse
I'm sorry to hear about the issues your having with your GI, that stinks. I hope that gets better. Post what you hear from your pharmcist or doctor.As far as those getting the most benefit are those that have SAD or GAD, I'm hearing from others who have depression as their #1 issue who are getting relief with EMSAM.
At few of us with SAD/GAD and depression (which seems to go along with SAD & GAD) are also taking a benzo like klonopin (me) and I really don't think the jury is in for EMSAM as mono therapy to treat SAD and or GAD.
But what EMSAM has certainly done for me is fix the other issues I was having, being tired, foggy headed, depressed, etc. which was either part of my anxiety disorter or was perhaps was further agrivated by the use of a benzo.
That said, in additioin to feeling more upbeat I am feeling more social and have been while dropping my dose of konopin. I'll know in time if EMSAM will work on it's own for all my issues or if I'll have to continue to blend it with klonopin. Either way, it's helped me a bunch and I'll do what works the best. Good luck, I hope you start feeling better soon. Rob
Posted by pulse on May 15, 2006, at 22:30:17
In reply to Re: Anyone Apply Emsam at night? » pulse, posted by RobertDavid on May 15, 2006, at 21:12:17
Thanks for your kindness, as always, Robert.
You may remember from your "First day" thread that indeed I DO have several anxiety disorders, but social anxiety is the one I DON'T (IMO and my therspist's) have. Some few may (?) have disagreed...I don't recall now.
Being an only child, as I am, one *must* be all things to all "men", I'm afraid, so public speaking, leading NAMI groups/ other, and having strong leadership qualities has come naturally for me, since I was very young. (It's those 1st time parents that are pretty nervous. HA!)
pulse
Posted by RobertDavid on May 16, 2006, at 2:25:36
In reply to Re: Anyone Apply Emsam at night? » RobertDavid, posted by pulse on May 15, 2006, at 22:30:17
> Thanks for your kindness, as always, Robert.
>
> You may remember from your "First day" thread that indeed I DO have several anxiety disorders, but social anxiety is the one I DON'T (IMO and my therspist's) have. Some few may (?) have disagreed...I don't recall now.
>
> Being an only child, as I am, one *must* be all things to all "men", I'm afraid, so public speaking, leading NAMI groups/ other, and having strong leadership qualities has come naturally for me, since I was very young. (It's those 1st time parents that are pretty nervous. HA!)
>
> pulse
Well being able to do well in social situation, public speaking is a real plus! When I was 25 I had to quit a job that paid $20,000 a month because I could no longer do the presentations at the meetings. They didn't really know what social anxiety was then or how to treat it. Years later klonopin bailed me out, got me out of the house, participating in life again, I just needed help with the depression brought on by SAD/GAD which EMSAM is resolving thankfully.Keep us posted on how your doing. I think with everones impute on this topic it will give a lot of people things to think about. It's good to think out of the box at times and to adjust and tweak these meds till you get it just right.
I thank you for all your information. Rob
Posted by pulse on May 16, 2006, at 2:37:01
In reply to Re: Anyone Apply Emsam at night? » pulse, posted by RobertDavid on May 16, 2006, at 2:25:36
So agree on thinking outside the box/ tweaking these meds. Believe I saw at least one other thread here where 2-3 folks have mentioned they've doing this tweaking for many years now.
Too bad - I agree with you that klonopin most definitely causes depression! The big difference between you and I is that it causes me insomnia at any dose, after one month. I can't imagine being able to take it all at night. Lucky you!
Yes, I will keep everyone posted, on the days I'm well enough. Thanks again.
pulse
Posted by RobertDavid on May 16, 2006, at 2:47:49
In reply to Re: Anyone Apply Emsam at night? » RobertDavid, posted by pulse on May 16, 2006, at 2:37:01
Yes, it's my take that savvy doctors know they must blend meds, know which med to use off label, for uses they are not approved for, play with doses, etc. as not everyone is lucky enough to just take one med that completely solves the problem.
Plus most people have more than one disorter, though there is typically one that is a primary disorter so treatment options need to be looked at for the various issues. For example, klonopin works great for anxiety, but may agrivate depression so a combo with a anti depressant, mood stabilizer or even mild stimulant like provigil can be the solution.
A real key to success with this is having a doctor that isn't phobic about certain classes of meds like benzo's and maois, not to mention having knoweldge to blend pr try other psycho tropic meds.
The good news is it seems more and more docors are being taught by the true experts on treatment options for the various mental disorters. That's why I feel there's an answer, a solution for just about everyone regarldess of past failures. That said I know it's just trial and error with these meds, but at least there's hope and you've got to keep trying to you find something that improves the quality of life. Rob
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.