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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 45. Go back in thread:
Posted by Phillipa on May 11, 2006, at 19:14:09
In reply to EMSAM - 3 weeks - 6mg/24h dose -not working for me, posted by Enigma on May 11, 2006, at 12:50:56
Enigma I picked-up on something. You said the fatigue started two days before the patch. Any reason why this might have happened. How did you feel about starting the patch? Hopeful it would immediately work? Were you coming off a med and not a two week wash out period? Love Phillipa
Posted by Enigma on May 12, 2006, at 11:44:19
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working for me » Enigma, posted by Phillipa on May 11, 2006, at 19:14:09
> Enigma I picked-up on something. You said the fatigue started two days before the patch. Any reason why this might have happened. How did you feel about starting the patch? Hopeful it would immediately work? Were you coming off a med and not a two week wash out period? Love Phillipa
Hi Phillipa.
Yes, that's the confusing part. I want to blame the Emsam for the fatigue, but yes, the fatigue started right before the Emsam. I was coming off another drug, but I did wait a week+ before starting the Emsam.
I was very "excited" to try the Emsam. I was really hoping it would be my miracle drug. I actually suggested it to my doctor.
I hope I can get a hold of the highest dose soon and give it a try. If my fatigue gets worse, then it would have to be the Emsam causing it, or at least playing a large role in it.
I found a new internist, and he thinks the fatigue is caused by my depression. Funny, I had to smile when he said "It's very hard to find a good psychiatrist". Anyway, I told him that I didn't think so (concerning the cause of the fatigue), as I normally have low energy and fatigue from depression, but *this* fatigue was *much* more intense and came on too quickly (in just 1 day).
He did agree to run a bunch of blood tests to see if anything viral is going on. A few weeks prior to this, I had a viral/sinus infection that lasted 6+ weeks, which is longest I've ever had. I took 3 different antibiotics to clear it, back to back.
I never felt like it was totally "cleared".During the last week or so, I felt the sinus pressure returning as well as the associated headaches.
He gave me a referral to an Ear/Nose/Throat doctor, but I haven't made the appt. yet. I know I should, but I've been down that road before (2 nasal surgeries so I can breath better through my nose which only marginally helped) and so forth, and I don't want that again. I'm more concerned the doc won't find anything causing the swollen sinuses.
I've always had this feeling like the sinus "thing" (I don't want to call it an infection because it might not be) is causing the fatigue, in that my body is fighting something viral, and I'm left very weak and tired.
I'll try to push myself to make that appt anyway, and get my butt down to the office to take the blood tests.
One of my problems has been the complete failure of my docs, p-docs and other types, to give me relief of any kind. Usually, the meds make me feel worse, which is really putting it lightly. So, I have very little faith left with docs in general. I almost feel like some people (like me) are just meant to suffer, as stupid as that sounds...
I generally have the "chemical" type of depression, not situational, as I like to call it. Unfortunately, I'm very depressed in the situational way as well (now), as I have little hope left at becoming healthy again (or at least able to work). I have an intense fear of the future now, as there's a deadline to the disability I get, even if it's still a year away. My employment technically ends in 2 weeks, and I now have to pay for Cobra, which is gonna be rough, finacially.
I'm also completely burnt out as a software engineer, but no other careers I'm qualified for will pay my bills.Anyway, I'm rambling as usual.. this is talk for the social board. Sorry. ;)
Posted by Paul on Long Island on May 14, 2006, at 9:57:36
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Enigma on May 12, 2006, at 11:44:19
> > Enigma I picked-up on something. You said the fatigue started two days before the patch. Any reason why this might have happened. How did you feel about starting the patch? Hopeful it would immediately work? Were you coming off a med and not a two week wash out period? Love Phillipa
>
> Hi Phillipa.
>
> Yes, that's the confusing part. I want to blame the Emsam for the fatigue, but yes, the fatigue started right before the Emsam. I was coming off another drug, but I did wait a week+ before starting the Emsam.
>
> I was very "excited" to try the Emsam. I was really hoping it would be my miracle drug. I actually suggested it to my doctor.
>
> I hope I can get a hold of the highest dose soon and give it a try. If my fatigue gets worse, then it would have to be the Emsam causing it, or at least playing a large role in it.
>
> I found a new internist, and he thinks the fatigue is caused by my depression. Funny, I had to smile when he said "It's very hard to find a good psychiatrist". Anyway, I told him that I didn't think so (concerning the cause of the fatigue), as I normally have low energy and fatigue from depression, but *this* fatigue was *much* more intense and came on too quickly (in just 1 day).
>
> He did agree to run a bunch of blood tests to see if anything viral is going on. A few weeks prior to this, I had a viral/sinus infection that lasted 6+ weeks, which is longest I've ever had. I took 3 different antibiotics to clear it, back to back.
> I never felt like it was totally "cleared".
>
> During the last week or so, I felt the sinus pressure returning as well as the associated headaches.
>
> He gave me a referral to an Ear/Nose/Throat doctor, but I haven't made the appt. yet. I know I should, but I've been down that road before (2 nasal surgeries so I can breath better through my nose which only marginally helped) and so forth, and I don't want that again. I'm more concerned the doc won't find anything causing the swollen sinuses.
>
> I've always had this feeling like the sinus "thing" (I don't want to call it an infection because it might not be) is causing the fatigue, in that my body is fighting something viral, and I'm left very weak and tired.
>
> I'll try to push myself to make that appt anyway, and get my butt down to the office to take the blood tests.
>
> One of my problems has been the complete failure of my docs, p-docs and other types, to give me relief of any kind. Usually, the meds make me feel worse, which is really putting it lightly. So, I have very little faith left with docs in general. I almost feel like some people (like me) are just meant to suffer, as stupid as that sounds...
>
> I generally have the "chemical" type of depression, not situational, as I like to call it. Unfortunately, I'm very depressed in the situational way as well (now), as I have little hope left at becoming healthy again (or at least able to work). I have an intense fear of the future now, as there's a deadline to the disability I get, even if it's still a year away. My employment technically ends in 2 weeks, and I now have to pay for Cobra, which is gonna be rough, finacially.
> I'm also completely burnt out as a software engineer, but no other careers I'm qualified for will pay my bills.
>
> Anyway, I'm rambling as usual.. this is talk for the social board. Sorry. ;)Hi Enigma, I just wanted to share with you my experience with Emsam 6 mg patch. I had been on prozac for many years and done very well with it. Wanting to lose weight and maybe have more of a sex drive, I foolishly went off the prozac. I was on nothing for months. But due to a variety of really bad events happening in my life, I found I needed to be on an antidepressant. I suffer from depression (chemical, as you refer to it), anxiety and OCD. The doctor put me on Lexapro, because it supposedly has less of the side effects I was concerned with. It seemed to work pretty well for the depression, but I literally could not stop eating, so I came off of that. My doctor and I agreed that I'd hold out as long as I could until the emsam patch was available. I went on it 1 month ago. Before I went on it, I was mildly depressed and a bit anxious. Within 3 days of going on it, I started spiralling downward into what may have been the worst depressive state I've ever been in, along with intense anxiety. Crying jags, feelings of hopelessness...the works. The doctor told me to hold out, that I just needed to give the emsam a chance to work. After another week or so, I was not getting better, clearly getting worse, and not knowing what to do. I finally decided that it was the emsam itself causing the intense depression and anxiety. I wore my last patch two weeks ago today. I've been on lithium to try to boost my mood as much as possible and tried xanax, ativan and klonopin for the anxiety. The lithium was meant as only a stopgap measure. I start back on prozac tomorrow, and I pray to God that it will be as effective as it was in the past.
The only reason I'm telling you all this is that it occurs to me that the symptoms you're suffering from may not be just the emsam "not working", but actually working against you. You might want to talk to your doctor about that possibility. It could be you just need a higher dosage or, like me, emsam might be totally wrong for you. Paul
Posted by Enigma on May 14, 2006, at 13:47:32
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Paul on Long Island on May 14, 2006, at 9:57:36
Thanks for the post Paul.
If this drug is working against me, it definately wouldn't be the first.
Both Cymbalta and Celexa instilled suicidal reactions from me. One got me a weekend stay at a mental facility. Celexa caused me to break down cying at a bar no less, in front of people I just met. That was a bad scene.
I'm so glad you have a drug that actually works for you. That sucks about the weight gain. Prozac gave me horrible anxiety attacks. I felt like I was losing my mind during these attacks. Klonopin and such couldn't combat this enough, so I had to stop. Anyway, I've been lucky in that I rarely the weight gain side-effect from medications. Unfortunately, I get *all* the other side-effects.
I've been in hell for the past few days (at least). The depression is so bad that I can't stop thinking about suicide and can't stand being concious. It takes every ounce of willpower I have left to stop myself. If it wasn't for what this would do to wife and kids, I'd be cremated already. I really wish I was kidding.
I hurt myself last night and I can't really explain why. I was considering checking myself into the hospital last night as I'm slowing losing control of my actions. I can't really continue to exist while feeling the way I do. It's just to painful to tolerate.
Anyway, I doubled up my Emsam patch today, so I guess I'm technically at the highest dose (they make). I have enough patches to do this for 8 days. Before that, I hope to get more Emsam, unless of course I go completely downhill (even though there's not much hill left to go down), then I'll quit the Emsam all together.... adding it to my large list of failed medications. I'm trying this (the med increase) because I'm basically desperate, and have no other alternative. Not sure if there are any more med I haven't tried yet.
I'm glad some people here know my pain. Friends and family are useless, even though *some* try and help. They just don't/can't understand.
Thanks for caring.
-E
Posted by Donna Louise on May 15, 2006, at 6:38:04
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Enigma on May 14, 2006, at 13:47:32
Enigma, I am really impressed that you are able to communicate at all even via that internet, at times I just can't even do that. I am very worried for you though, maybe a stay in the hospital while you get through the suicidal ideations and what sounds vaguely like a practice attempt when you say you hurt yourself. Let the hospital take care of you for a bit,hmm?
And, as an aside, I take provigil for excessive daytime sleepiness that started about 4 years ago with one of those ssri's..can't think of the..zoloft, that one. I still take it, the provigil that is, even though I am on the patch and not needing to sleep all day because it does lift my mood and help me to desire to be around people. I have been able to halve the dose with the patch though. I am only just starting my third week on it.
Anyway, at least please keep writing so we know you are with us.Donna
Posted by pulse on May 16, 2006, at 3:35:46
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Enigma on May 14, 2006, at 13:47:32
Please! - the pkg. inserts WARNS: NEVER put 2 patches on at the same time EVER.
I do feel for you - I am having a very rough time, regarding other problems with Emsam.
I also agree that perhaps a stay in ths hospital is now warranted for you. Most don't like to go, altho I always end up letting go/ biting bullet... and putting myself in - 3 or 4 times now, although the last time was amost nine yrs. go. PLEASE consider going in!
pulse
Posted by Donna Louise on May 16, 2006, at 6:42:20
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo » Enigma, posted by pulse on May 16, 2006, at 3:35:46
Posted by Enigma on May 16, 2006, at 23:14:05
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo » Enigma, posted by Donna Louise on May 15, 2006, at 6:38:04
Pulse and Donna, thanks a great deal for the concern. Nice to know people care. ;)
I'm still at home, and feeling a bit better (well, a good deal better). It *seemed* like adding the two patches helped, and almost immediately too.
Thanks for the warning about not wearing two patches. I thought that 2 6mg/24h patches would be equal to 1 12mg/24h patch, but I'm guessing from that warning that it doesn't work that way or is there some other reason not to do it?
I seem to be doing ok with the 2 patches though.. 3rd day now.. or is it the 2nd? Hmmm. Anyway, I was able to move my p-doc appt up a week (so I went today) and got my new script for the 12mg/24 dose. The Tyramine and med restrictions will be in place, but that's a minor inconvenience IF my depression gets better (diminishes rather). Wouldn't better depression be *worse*? :)
I'm going to get some blood tests done tomorrow, so I'll hit the pharmacy then too. I have a feeling they won't have the Emsam in stock, especially the highest dose, so they will most likely have to order it, like last time.
I was on provigil once for the fatigue, but it didn't help. We didn't play around with the dosage though, so I'd definately try it again. I mentioned it to my doc, but she didn't know if I could take it with Emsam. Funny, she actually asked ME to look up any possible interactions with Emsam and call her back so I can get a script. Jeez.. Maybe she should pay per visit instead?
I hear you about getting on the net.. I like to write/complain/whine/beg for help/help others/did I say whine already? and I find it helps me to write. Some days I don't have the energy or desire to do it, and other days I do. You can tell I like to write, as my messages are always a mile long. :)
I did "hurt" myself (utility knife blade) the other day, but not to commit suicide. I'm not exactly sure why I did it. For some reason, I wanted to see my own blood. That sounds insane right? Hmmm. I did it on my left hand, on the top, where I can always see it. I think I wanted a physical reminder that it's "stupid" (and painful) to hurt yourself. If I'm lucky, it will leave a scar, and I can always look at it and "reflect" upon it. I dunno..
I forgot to mention (if anyone is still reading this)... I'm getting application site reactions (rashes) where I put the patches. So, I have to keep moving them to a different place each day, as two-three days in the same place causes a rash. :(
Take care.
Also, I'm curious what other peoples' depression is like. I'll probably start a thread on the social board asking about it.
Posted by cecilia on May 17, 2006, at 5:59:24
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Enigma on May 16, 2006, at 23:14:05
Of course the drug company is going to tell you not to put 2 patches on at once-they'd rather you pay $500 for a new box of 30 and throw them out if you can't tolerate the higher dose. Anyone know if there really is a biochemical reason why 2 6-mg patches would not be equivalent to 1 12-mg patch. I don't know, just asking. I don't trust drug companies, especially with this obscenely priced drug. A cynical part of me is wondering if some of the people who are having great reactions may be drug company "plants". Cecilia
Posted by cecilia on May 17, 2006, at 6:07:34
In reply to Re: EMSAM - 3 weeks - 6mg/24h dose -not working fo, posted by Enigma on May 16, 2006, at 23:14:05
Posted by Enigma on May 17, 2006, at 11:45:58
In reply to Emsam two patches at once, posted by cecilia on May 17, 2006, at 5:59:24
> Of course the drug company is going to tell you not to put 2 patches on at once-they'd rather you pay $500 for a new box of 30 and throw them out if you can't tolerate the higher dose. Anyone know if there really is a biochemical reason why 2 6-mg patches would not be equivalent to 1 12-mg patch. I don't know, just asking. I don't trust drug companies, especially with this obscenely priced drug. A cynical part of me is wondering if some of the people who are having great reactions may be drug company "plants". Cecilia
Heh, I hear you. I'm no fan of the pharmaceutical industry, for many, many reasons.
I got worried, and only put 1 patch on today... The pharmacy says they will have my new 12mg dose of the drug tomorrow, so I guess I can tolerate 1 day with the lower dose. I agree that 2 patches probably isn't a real issue, but who knows.
I'm lucky that my insurance is paying for the drug, but it's still more than I pay for any other drug. Most drugs I get are $10, Emsam and Lunesta are $30 each, so $60 a month for me.
My old insurance used to have a killer deal for a 3 month supply of meds (mail order).. only $8 for 90 days!! and for most any drug. But, of course, they changed it, and now it's exactly the same price as paying for it per month. The Anthem I have now had no price break for a 3-month supply. What's the point then?
Mood isn't bad today, but man, I'm exhausted. Didn't take a Lunesta, slept horrible, and I'm really feeling it. :(
It's nice to have the sun out again. It's been raining here in NH for 1 week straight. Lots of places got flooded, roads washed away, etc. No damage near my house though, which is good.
Take care.
Posted by aabag on May 17, 2006, at 12:25:55
In reply to Emsam two patches at once, posted by cecilia on May 17, 2006, at 5:59:24
Drug company plant? I suppose its technically possible, but this screen name aabag is my second one. I used to go by pseudonym, before I for whatever reason, was un-able to use the account. I have been coming to this board since 2001-ish and insinuating I'm a plant for having success on EMSAM is ****. You fill in the blank. Now, I know you'll defend yourself by saying, I was just cynically wondering, not implicating, but I'm here to tell you stop wondering in my case.
Posted by ttee on May 17, 2006, at 21:05:43
In reply to Re: Emsam two patches at once, posted by aabag on May 17, 2006, at 12:25:55
Is paranoia a side effect from Emsam?
Posted by Phillipa on May 17, 2006, at 21:58:29
In reply to Re: Emsam two patches at once, posted by ttee on May 17, 2006, at 21:05:43
Oh no you're paranoid? say it's not true. Love Phillipa
Posted by cecilia on May 18, 2006, at 3:23:26
In reply to Re: Emsam two patches at once, posted by aabag on May 17, 2006, at 12:25:55
Don't worry, I wasn't insinuating anything about you or anyone else in particular. There are so many on Emsam now I can't keep track of who's having good reactions and who's having bad reactions. I'm just very cynical about drug companies in general and the Emsam manufacturer in particular because of its ridiculous price. To charge that much-I mean it wasn't even a new drug, just an old one in a new format. So it isn't that I have suspicions about anyone here, just that I wouldn't put it past the drug company to use tactics like that. That would be mild compared to some of the other tactics I've read about them using, like some of the tactics
they used to get doctors to prescribe Neurontin off-label, or all the tweaking and renaming all the companies do when their patents are about to expire. Cecilia
Posted by lymom3 on May 18, 2006, at 6:30:49
In reply to Re: Emsam: aabag, posted by cecilia on May 18, 2006, at 3:23:26
I am having a good reaction to Emsam but I'm with you on drug costs. My son takes Focalin XR for his ADHD. He started on it when it was fairly new and the first month I had to pay for the prescription until I could get the insurance company to cover it. It was over $400. At least that was a "new" drug. Not totally new, just a refined version of an "old" drug but ridiculous to me.
Posted by ttee on May 18, 2006, at 9:03:01
In reply to Re: Emsam: aabag, posted by lymom3 on May 18, 2006, at 6:30:49
I was just teasing. Drug costs are a big problem and there does not seem to be any quick fixes. The FDA made Emsam jump through a million hoops before they gave it the low dose approval and that cost an extra 4 years and who knows how many millions of dollars. The more trouble the drug company has with the FDA, the more they have to charge for the end product to recover their costs. Last time I checked, the drug companies are in the business of making money and if we take that away from them, there won't be any new meds discovered. Since Emsam is never going to be a 1st or 2nd line med choice, it is never going to make big bucks for the drug company. For the majority with its only FDA approved indication of Depression, Emsam is going to be reserved for those that have already spent thousands on other "safer" meds first. If the FDA had approved Emsam 5 years ago, I would guess the cost would be the same as any other new AD. No matter how well Emsam works, it will never be a billion dollar seller like the other AD are, or were before they went generic. Emsam will never be a blockbuster for any of the drug companies involved. The target market for Emsam is too small being the minority of us that have failed every other possible med there is. In this day and age that it only makes economic sense for the drug companies to develop blockbuster meds, I feel lucky that Emsam got through the drug company’s bean counters objections.
A company called Neurocrine just lost 75% of it's market value on Tuesday, when the FDA said it didn't have time to review the new drug application and didn't approve Indoplin. Neurocrine is working on 3 other new meds for depression. This FDA decision is going to hurt all the drug companies working on new meds and we will end up footing the bill for these added costs. In my opinion, the FDA needs to be totally reorganized.
Posted by aabag on May 18, 2006, at 13:41:27
In reply to Re: Emsam: aabag, posted by cecilia on May 18, 2006, at 3:23:26
Anyway, another thing I noticed about EMSAM is that exercise increases its benefits. So just going for a run in the afternoon, which I've been more inclined to do anyway, seems to help. That, and making sure to get enough sleep. So I guess that's a pretty old prescription, sleep and exercise, but in combination w/ an MAO-inhibitor, it seems more pronounced.
Posted by Iansf on May 19, 2006, at 16:52:06
In reply to Re: Emsam: aabag, posted by ttee on May 18, 2006, at 9:03:01
> Since Emsam is never going to be a 1st or 2nd line med choice, it is never going to make big bucks for the drug company. For the majority with its only FDA approved indication of Depression, Emsam is going to be reserved for those that have already spent thousands on other "safer" meds first.>
From the initial responses I've read about, I think Emsam WOULD have the potential to become a 1st or 2nd choice. Both the side effect and success profiles appear to be much better than with most antidepressants. But the high cost is going to make it all but impossible for Emsam to gain widespread use. It looks to me more like a case of a drug company finding a way to make a lot of money off a new product while making sure it doesn't cut deeply into the sales of its existing products.
Posted by ttee on May 20, 2006, at 12:06:44
In reply to Re: Emsam: aabag » ttee, posted by Iansf on May 19, 2006, at 16:52:06
First, BMS makes NO other competing anti-depressants to worry about. BMS is not going to give a crap about dipping into Lexapro sales; in fact they would like that to happen. Paxil, Zoloft, and Celexa are already off patent. Effexor will follow the end of the year.
Emsam still has the same drug/drug interactions that are the main reason most PCP's and pdocs were scared to prescribe Nardil or Parnate in the first place. Nardil and Parnate combined only represented 0.01% of all anti-depressants prescribed. In that over 80% of all anti-depressants are prescribed by PCP, not psychiatrists, for a drug to become a blockbuster it needs to have full support from the majority of the PCP's. PCP's are scared to death of the liability to prescribe any MAOI's. That will not change until Emsam has been out for over 7 years and there have been no deaths from drug or dietary problems. Even BMS in the financial statements estimates peak Emsam sales to be around $200 million per year. Compare that to Effexor that makes over 3 Billion per year. Since the average new drug takes $800 million to get FDA approval, it is going to take many years of only making $200 million per year for BMS to breakeven on Emsam. If they can get EMSAM approved for other indications like ADHD, Anxiety, Dementia, etc. then it might become more then a minor footnote in the annual financial statements for the drug company.
As far as knowing how well Emsam works, I doubt the 5 or 8 people on the site represent a scientific study as to efficiency. In addition, I think it is about even as to those that are finding it helpful and those that are discontinuing Emsam early because they were going out of the mind.
Amphetamines have a similar fast response and low side effect profile as Emsam. But I don't think amphetamines are the long term answer for many.
I would be worried about a doctor that treats a first time depressed patient with Emsam before seeing if and SSRI (generic) or SNRI might do the trick without the fuss of potentially fatal drug/drug interactions with something as simple as getting Novocain at the dentist's office.
Time will tell and I think Emsam is a great alternative to the older MAOI's for a certain subtype of depressed patients. The more different treatments there are, the better the chances people have to get a response.
Good luck all your Emsam'ers!!
Posted by Enigma on May 21, 2006, at 0:25:30
In reply to Re: Emsam: aabag, posted by aabag on May 18, 2006, at 13:41:27
> Anyway, another thing I noticed about EMSAM is that exercise increases its benefits. So just going for a run in the afternoon, which I've been more inclined to do anyway, seems to help. That, and making sure to get enough sleep. So I guess that's a pretty old prescription, sleep and exercise, but in combination w/ an MAO-inhibitor, it seems more pronounced.
Man, I wish I could do that. Exercise that is. To depressed, un-energetic, and non-motivated to even begin. Even something like walking. Sad.
Got my new 12mg/24 patch, and it's *bigger* than then 6mg patch... maybe by about 50-75%.. I didn't measure it yet.
I'm getting skin reactions to wherever I put the patch, and I'm running out of new places to put the patch (new being a place where it won't come off by muscles flexing, etc, and where there is no hair.. I guess I could shave part of my quads and put the patches there.. dunno.. I've had rashes for days now and they are healing very very slowly.
Mood still aint great, and I'm still exhausted (actually got worse again for seemingly no reason). Needed to take naps two days in a row, or fall asleep on the floor.
This is hell. I can't accept another AD failure. There's almost nothing left to try.
Maybe I'll be lucky next time I'm out, and a plane will land on me and put me outta my misery.
Posted by aabag on May 21, 2006, at 13:29:45
In reply to Re: Emsam: aabag, posted by Enigma on May 21, 2006, at 0:25:30
Maybe you can remove the patch in the shower and replace it thereafter? Do you have rashes if you put on a band-aid, i.e. is it a skin thing? I haven't noticed any rashes, other than some slight redness that goes away after certainly less than a day. I generally put the patches on my quads because I just don't notice them there, whereas on my back, the muscles/skin tend to move around and therefore wrinkle up the putch somewhat. As for shaving your quads, bikers do it :)
Did any other anti-depressants help you? reason I ask is that they didn't help me, whereas a benzo did, some I'm curious if you fit that profile. As for exhaustion, do you attribute that to lack of restorative sleep?
Posted by SFY on May 21, 2006, at 16:52:37
In reply to Re: Emsam: aabag, posted by ttee on May 20, 2006, at 12:06:44
> Even BMS in the financial statements estimates peak Emsam sales to be around $200 million per year. Compare that to Effexor that makes over 3 Billion per year. Since the average new drug takes $800 million to get FDA approval, it is going to take many years of only making $200 million per year for BMS to breakeven on Emsam.
Ignoring the fact that the $800 million stat has very little basis in reality (It arose from one study almost 20 years ago that has been adjusted for inflation ever since), Emsam isn't an average new drug by any means.
The bulk of the figure cited includes the money spent on drugs that didn't make it through the development process. Emsam, being based on the already developed selegiline, isn't one of these drugs.
Somerset didn't have to put any money into actual drug discovery and development. Selegiline was already out there for the taking. While not a small task, all that needed to be done was to develop a transdermal delivery system for selegiline and then test its efficacy and side effect profile.
Posted by ttee on May 22, 2006, at 16:53:03
In reply to Re: Emsam: aabag, posted by SFY on May 21, 2006, at 16:52:37
I admit I am not privy to what Somerset paid to get EmSam approved, but I know it took much longer than anyone anticipated and whenever that happens the expenses go way up. The clinical trials are the most expensive part and EmSam had plenty of those, plus the tyramine studies, plus a FDA non approval, then a FDA advisory committee meeting. That all costs lots of $$$$. I still think the reason Emsam costs more than other new AD's is because it is a nitche med for those that have tried everything else prior. There may be 12 million American's with depression, but there is a much smaller amount of the 12 million that don't respond to conventional AD's. Since Emsam sales will never be on the volume of Effexor, they have to charge more for the EmSam they can sell. In this day and age when the drug companies only want blockbuster meds, I still feel lucky that EmSam made it. If Emsam worked for me after all the cheaper meds had failed, it would be worth every penny they charged me.
Posted by Iansf on May 24, 2006, at 0:39:00
In reply to Re: Emsam: aabag, posted by ttee on May 22, 2006, at 16:53:03
<If Emsam worked for me after all the cheaper meds had failed, it would be worth every penny they charged me. >
To the tune of more than $5,000 a year?
Many people who suffer from long-term depression earn below-average incomes and can in no way afford to pay this kind of price.
Meanwhile the CEO of BristolMyers Squibb squeezes out a meager livelihood of $40 million a year.
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