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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 SLS on September 22, 2006, at 7:50:20
How many people are feeling MUCH better on this drug?
I see people getting an energizing effect and an anxiolytic effect during the first few weeks, but that's about it.
Is there anyone for whom Emsam is a magic pill?
- Scott
Posted by Crazy Horse on September 22, 2006, at 8:40:10
In reply to Emsam, posted by SLS on September 22, 2006, at 7:50:20
> How many people are feeling MUCH better on this drug?
>
> I see people getting an energizing effect and an anxiolytic effect during the first few weeks, but that's about it.
>
> Is there anyone for whom Emsam is a magic pill?
>
>
> - Scott
Nothing magic about EMSAM for me. And, btw i haven't seen it in the pill form Scott ;). FOR ME, EMSAM was weak...not even close to the other MAOI power house drugs Nardil and Parnate. The main effect i had from EMSAM was insomnia. And, from the majority of threads/posts i have read here it doesn't seem to be as effective as some thought it would be. I also thought the patch transdermal delivery system was a pain in the *ss, with the rashes and problems with the patch sticking, i'd much rather swallow a pill.-Monte
BUT, IMPORTANT!!! Just because it didn't work for me, does not mean it might not be an excellent medication for someone else.
Posted by Phillipa on September 22, 2006, at 10:47:40
In reply to Re: Emsam, posted by Crazy Horse on September 22, 2006, at 8:40:10
Maybe Robert David will pop in I doubt it. My last correspondence with him that the klonopin was his main med and Emsam just for a bit more energy. I want to know the same thing. Love Phillipa
Posted by JOP on September 22, 2006, at 11:25:39
In reply to Emsam, posted by SLS on September 22, 2006, at 7:50:20
> How many people are feeling MUCH better on this drug?
>
> I see people getting an energizing effect and an anxiolytic effect during the first few weeks, but that's about it.
>
> Is there anyone for whom Emsam is a magic pill?
>
>I am at the end of my fourth week on Emsam, and like Crazy Horse, it has done nothing to improve my mood. Aside from some itching that has since subsided, I’m not convinced that this is something I will stick with much longer. That said, I would reiterate that I am not you and you might get some decent mileage out of it.
However, unlike Crazy Horse, I thought the delivery mechanism of the patch was very convenient. I would just slap it on and go.
This is my first foray into the world of MAOIs. Almost a last ditch attempt to try to find something that works to treat chronic major depression. As an aside to anyone reading, do you think 4 weeks is enough time for an Emsam trial? I have an appointment with my pdoc tomorrow and was thinking about increasing the dosage up to 9mg. BUT . . . . if I do that, it is highly recommended that I follow the dietary restrictions for all MAOIs (this still seems debatable). If I have to follow a diet, I think it would make more sense to move to a drug with a more established track record like Parnate or Nardil (which are CONSIDERABLY cheaper). Does this seem logical to anyone?
Also, is there a standard washout time for Emsam? I know the half life of Selegiline is really short (2-3 hrs?) so I’m thinking I could get away with a couple of days of being drug free instead of waiting 2 weeks to start another MAOI. Any thoughts on this?
I know I am going to have to educate my doctor on this one, I don’t think he feels all that comfortable with medication in general (yet he’s a physician??????????) and I am his first on Emsam. He would rather rely on therapy to try to work through things. But at this point my depression has gotten so bad I really don’t feel like talking about anything – but this post is really long. Sorry.
Posted by SLS on September 22, 2006, at 15:09:29
In reply to Re: Emsam, posted by Crazy Horse on September 22, 2006, at 8:40:10
> > Is there anyone for whom Emsam is a magic pill?
> Nothing magic about EMSAM for me. And, btw i haven't seen it in the pill form Scott ;).
Yes, smart guy...
:-)
- Scott
Posted by jaclinhyde on September 22, 2006, at 16:15:41
In reply to Re: Emsam » Crazy Horse, posted by SLS on September 22, 2006, at 15:09:29
I definitely feel better on Emsam but it is just a normal feeling and nothing like the almost euphoric (at least imho) feeling I got from Nardil, Parnate and Marplan. But I pushed it to a higher dose (18mg a day or 2 9mg patches.) I have noticed that I am much more sensitive to things that never bothered me on the other MAOI's such as nasal spray (I know, a no-no but never gave me a problem) and even caffeine. The one thing that I do like about Emsam is that, like it's pill form Deprenyl it is supposed to extend life-span. Here is a link to 3 articles (there are more) on the bonus benefits of using selegline.
http://www.smart-drugs.net/ias-deprenylJS.htm
Terri
Posted by WeeWilly on September 22, 2006, at 16:22:08
In reply to Re: Emsam, posted by JOP on September 22, 2006, at 11:25:39
> > How many people are feeling MUCH better on this drug?
> >
> > I see people getting an energizing effect and an anxiolytic effect during the first few weeks, but that's about it.
> >
> > Is there anyone for whom Emsam is a magic pill?
> >
> >
>
> I am at the end of my fourth week on Emsam, and like Crazy Horse, it has done nothing to improve my mood. Aside from some itching that has since subsided, I’m not convinced that this is something I will stick with much longer. That said, I would reiterate that I am not you and you might get some decent mileage out of it.
>
> However, unlike Crazy Horse, I thought the delivery mechanism of the patch was very convenient. I would just slap it on and go.
>
> This is my first foray into the world of MAOIs. Almost a last ditch attempt to try to find something that works to treat chronic major depression. As an aside to anyone reading, do you think 4 weeks is enough time for an Emsam trial? I have an appointment with my pdoc tomorrow and was thinking about increasing the dosage up to 9mg. BUT . . . . if I do that, it is highly recommended that I follow the dietary restrictions for all MAOIs (this still seems debatable). If I have to follow a diet, I think it would make more sense to move to a drug with a more established track record like Parnate or Nardil (which are CONSIDERABLY cheaper). Does this seem logical to anyone?
>
> Also, is there a standard washout time for Emsam? I know the half life of Selegiline is really short (2-3 hrs?) so I’m thinking I could get away with a couple of days of being drug free instead of waiting 2 weeks to start another MAOI. Any thoughts on this?
>
> I know I am going to have to educate my doctor on this one, I don’t think he feels all that comfortable with medication in general (yet he’s a physician??????????) and I am his first on Emsam. He would rather rely on therapy to try to work through things. But at this point my depression has gotten so bad I really don’t feel like talking about anything – but this post is really long. Sorry.
>Hello JOP,
I have also been treated with Emsam for about 1 month. I have previously been on Parnate(many times) and Nardil. I would recomend upping your dose, I am currently using the 12mg patch. My response on the Emsam alone is minimal, but when I add 15 or 20mg of Adderall I do get some positive response. I'm hopeing I can get a decent response to just Emsam alone. Since you have been on the Emsam 4 weeks allready, I would suggest again to push the dose higher. Are you takeing anything along with the Emsam? Parnate and Nardil are usefull medications. They are certainly harsher than Emsam and more likely to have more difficult side effects. Not being in a patch form is another draw back compared to Emsam. So give Emsam a complete trial before or if you move on. Of course I can't say I have allways followed this type of advice. If I go another 2 weeks or so and I can't get a significant effect on Emsam alone I will be questioning how much longer to extend this trial. Possibly going higher than 12mg.
Best wishes.
Posted by JOP on September 22, 2006, at 16:39:08
In reply to Re: Emsam, posted by WeeWilly on September 22, 2006, at 16:22:08
> Hello JOP,
>
> I have also been treated with Emsam for about 1 month. I have previously been on Parnate(many times) and Nardil. I would recomend upping your dose, I am currently using the 12mg patch. My response on the Emsam alone is minimal, but when I add 15 or 20mg of Adderall I do get some positive response. I'm hopeing I can get a decent response to just Emsam alone. Since you have been on the Emsam 4 weeks allready, I would suggest again to push the dose higher. Are you takeing anything along with the Emsam? Parnate and Nardil are usefull medications. They are certainly harsher than Emsam and more likely to have more difficult side effects. Not being in a patch form is another draw back compared to Emsam. So give Emsam a complete trial before or if you move on. Of course I can't say I have allways followed this type of advice. If I go another 2 weeks or so and I can't get a significant effect on Emsam alone I will be questioning how much longer to extend this trial. Possibly going higher than 12mg.
> Best wishes.Thanks for the info. On 12mg, are you following the diet? The primary reason I chose Emsam first was the lack of dietary restrictions at the lowest dose.
Posted by Jost on September 22, 2006, at 19:19:41
In reply to Re: Emsam » WeeWilly, posted by JOP on September 22, 2006, at 16:39:08
Why not use adderall, though? If it works-- well-- then it's working.
Also it might take longer for Emsam to be really effective.
I wasn't following the maoi diet-- although I was only taking effectively 9 mg a day. I didn't use nose spray. No problem with coffee.
Jost
Posted by Jost on September 22, 2006, at 19:22:10
In reply to Emsam, posted by SLS on September 22, 2006, at 7:50:20
I am. But you probably know that. (or not?--but anyway, I am.)
Jost
Posted by WeeWilly on September 22, 2006, at 19:38:49
In reply to Re: Emsam » WeeWilly, posted by JOP on September 22, 2006, at 16:39:08
I have been on and off Parnate for about 20 years, and have'nt run into any problems with food ineractions. Emsam even at a higher rate is not likely to be risky. Number one because of selegines maoi reversibility and number 2 due to the transdermal system benefits. Hopefully you have better insurance than I do. I'm paying for most of mine out of pocket at present. That will have to change. Best wishes
Posted by JOP on September 22, 2006, at 19:47:55
In reply to Re: Emsam » JOP, posted by Jost on September 22, 2006, at 19:19:41
> Why not use adderall, though? If it works-- well-- then it's working.
>
> Also it might take longer for Emsam to be really effective.
>
> I wasn't following the maoi diet-- although I was only taking effectively 9 mg a day. I didn't use nose spray. No problem with coffee.
>
> JostRitalin 60mg 3x per day -- no response @ highest dose
Adderall 20mg 3x per day -- no response @ highest dose
Dexedrine 30mg 3x per day -- looked very promising at highest dose but pooped out within a weekbecame really frustrated and wanted to just get out of bed and have one day with some energy -- crushed and snorted 40mg of ritalin. absolutely nothing happened so i went back to bed.
next is Provigil, but it really doesn't look promising given my response to other stimulants.
Posted by Jost on September 22, 2006, at 21:58:14
In reply to Re: Emsam » Jost, posted by JOP on September 22, 2006, at 19:47:55
Sorry, I must have confused you with someon else who posted about adderall and emsam higher on the board.
I'm amazed you had no reaction to any stimulants. Sorry you'd have no luck so far.
The maoi diet shouldn't be an issue on 9 mg, according to the Somerset presentation to NIMH when they applied for the patch.
They agreed to dietary restrictions mostly to apply time for further evidence to be presented, apparently.
You can check it out. They did a lot of tyramine challenges and it seemed almost impossible to eat enough tyramine to cause any hypertension-- at least as far as they checked.
If you've never had an maoi, you might be careful for a while-- just to be certain, in your case. But the diet isn't that tough--
Jost
Jost
Posted by SLS on September 23, 2006, at 4:11:09
In reply to Re: Emsam » SLS, posted by Jost on September 22, 2006, at 19:22:10
> I am. But you probably know that.
I didn't, but Woohoo!
:-)
That's great.
Do you feel that you have recovered a clarity and fluidity of thought and a power of memory, the magnitudes of which you could hardly appreciate while depressed?
I am always stupefied when I experience one of my temporary improvements at how much this illness impacts on my cognitive abilities.
- Scott
Posted by jealibeanz on September 23, 2006, at 6:19:37
In reply to Re: Emsam, posted by WeeWilly on September 22, 2006, at 16:22:08
Is it possible that those who have been on Nardil or Parnate are less likely to get a good response?
Posted by SLS on September 23, 2006, at 7:53:48
In reply to Re: Emsam, posted by jealibeanz on September 23, 2006, at 6:19:37
> Is it possible that those who have been on Nardil or Parnate are less likely to get a good response?
Yes. It is possible.
Blueberry said it very well in a recent post that I believe is still on the board somewhere. Anyway, it says basically that a drug goes in, makes changes in the brain, leaves, and the changes remain. The next drug now sees a changed brain and not the original one. This changed brain might not be as responsive to this second drug as the original brain might have been.
That someone becomes less responsive to the same drug upon repeated administrations is evidence that this happens.
- Scott
Posted by KayeBaby on September 23, 2006, at 13:24:19
In reply to Re: Emsam » Jost, posted by JOP on September 22, 2006, at 19:47:55
I get no physical energetic benefits from the samed drugs below. I am taking a drug called Didrex (old diet med) and it works very well for this purpose. I have been taking it for about 4 years. Seems like the "good stuff" is to focused or clean. I require caffiene and a stimulant with peripheral cns effects. Also, I have found that smaller doses of the stims you mentioned work better than larger.
You might try the Dexedrine in the instants release. It is like a different med than the spansules for me.
Oh-never use generics on these meds. I don't know why but I have no luck with them.I know what it's like to just feel like you cannot move.
Wishing you luck,
Kaye
> Ritalin 60mg 3x per day -- no response @ highest dose
> Adderall 20mg 3x per day -- no response @ highest dose
> Dexedrine 30mg 3x per day -- looked very promising at highest dose but pooped out within a week
>
> became really frustrated and wanted to just get out of bed and have one day with some energy -- crushed and snorted 40mg of ritalin. absolutely nothing happened so i went back to bed.
>
> next is Provigil, but it really doesn't look promising given my response to other stimulants.
Posted by Jost on September 23, 2006, at 21:35:16
In reply to Re: Emsam » Jost, posted by SLS on September 23, 2006, at 4:11:09
Now that you mention it... Although I'm lapsing into incoherence already.
I'm going to be really bummed if I can't take emsam again.
I mentioned above that I'm having a reaction to what probably was a pretty bad overdose--probably some defective patches-- combined with exercise on hot days-- The reaction has lasted for about 5 days since I stopped the patch, but I'm not sure what that means-- (although I'm beginning to wonder--)
Emsam seems to be a really good drug, with some need for improvement of the delivery system. It would be great if your pdoc comes around. Don't see why he wouldn't, though. At worst, you have to read labels if you use products from health food stores, and be careful about a few medications-- it isn't all that risky.
My pdoc has used Maois pretty regularly for a long time, and has been open to prescribing them more than most docs. Btw, Babblemail me if, at some point, you think it would help if your pdoc talked to mine. I can ask mine and let you know-- and would be surprised completely if he wouldn't be quite willing.
Jost
This is the end of the thread.
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