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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Monica L on November 5, 2009, at 17:28:04
Well, I went to the pdoc and we decided to start the 2 week wash out. He wants me to start EMSAM on Nov 19. Does anyone know if you can take Provigil during the wash out before EMSAM? I know you can with Parnate, anyways he wouldn't prescribe it, he said I have to be off EVERYTHING. I really hope I can do this!!So what is EMSAM like? What is the usual starting dosage?
Thanks everyone!!
Posted by Phillipa on November 5, 2009, at 17:57:30
In reply to Starting two week wash out...I'm scared!!!, posted by Monica L on November 5, 2009, at 17:28:04
Monica 6mg patch but that has no restrictions so why a washout? If not a lot of responses google Dr. Bob's side of google on meds page old posters will come up or google same place Robert David the first to try Emsam he loved it. Love Phillipa
Posted by maxime on November 5, 2009, at 18:02:02
In reply to Starting two week wash out...I'm scared!!!, posted by Monica L on November 5, 2009, at 17:28:04
You would be able to take Provigil during the washout. He probably doesn't want you to take it because EMSAM isn't supposed to be taken with stimnulants even though it can be done.
The two week washout is hell, but it's really important. I wish you all the best.
Posted by floatingbridge on November 6, 2009, at 2:03:48
In reply to Starting two week wash out...I'm scared!!!, posted by Monica L on November 5, 2009, at 17:28:04
> Well, I went to the pdoc and we decided to start the 2 week wash out. He wants me to start EMSAM on Nov 19. Does anyone know if you can take Provigil during the wash out before EMSAM? I know you can with Parnate, anyways he wouldn't prescribe it, he said I have to be off EVERYTHING. I really hope I can do this!!So what is EMSAM like? What is the usual starting dosage?
>
> Thanks everyone!!Monica,
I'm pulling for you. Good luck! I don't agree w/ you doc--you can google other threads on emsam and washout strategies--however, you doc sounds like mine :-)
fb
Posted by Nadezda on November 6, 2009, at 7:46:40
In reply to Starting two week wash out...I'm scared!!!, posted by Monica L on November 5, 2009, at 17:28:04
He might be concerned that even though provigil was okay with parnate, it might be a problem with Emsam. He could want to start you on the Emsam and then try provigil with it-- in order to be very protective of you.
I"m really sorry if you have a rough time. Would he give you some seroquel, or at least xanax to try to ride out the mood swings and instability? I do think it you should taper rather than go cold turkey, if you're taking parnate now, even if it lengthens the wait.
I take emsam and have had a very good response. So I hope you can take some comfort in the prospect of getting a very good drug soon.
good luck,
Nadezda
Posted by bulldog2 on November 6, 2009, at 10:55:39
In reply to Starting two week wash out...I'm scared!!!, posted by Monica L on November 5, 2009, at 17:28:04
> Well, I went to the pdoc and we decided to start the 2 week wash out. He wants me to start EMSAM on Nov 19. Does anyone know if you can take Provigil during the wash out before EMSAM? I know you can with Parnate, anyways he wouldn't prescribe it, he said I have to be off EVERYTHING. I really hope I can do this!!So what is EMSAM like? What is the usual starting dosage?
>
> Thanks everyone!!I initially experienced a nice dopamine rush. I would say a moderate euphoria. When I reported this to my p-doc he took me off the patch. He said euphoria in any form is not acceptable.
Posted by Phillipa on November 6, 2009, at 17:51:12
In reply to Re: Starting two week wash out...I'm scared!!!, posted by bulldog2 on November 6, 2009, at 10:55:39
Why you weren't manic right? Makes no sense to me. Phillipa
Posted by floatingbridge on November 6, 2009, at 17:58:45
In reply to Re: Starting two week wash out...I'm scared!!! » bulldog2, posted by Phillipa on November 6, 2009, at 17:51:12
> Why you weren't manic right? Makes no sense to me. Phillipa
That's what I was thinking Phillipa, but though maybe I had misremembered Bulldog's dx.
I know for BP II, hypomania is serious and a sign of de-stabilization. Right now, if I could just get a drop of that good feeling. Sigh. But that isn't how it works, is it?
So Bulldog, no hypomania on parnate? Hmmm.
fb
Posted by Monica L on November 6, 2009, at 18:12:33
In reply to Re: Starting two week wash out...I'm scared!!! » Phillipa, posted by floatingbridge on November 6, 2009, at 17:58:45
So far so good, this is only my second day off the paxil and no withdrawl symptoms. Hopefully it stays this way!! Should I already be feeling the withdrawl from the Paxil? As far as being depressed, I think the ECT helped with that, but I still and always have had, the low dopamine issue. I've dealt with all the symptoms of low or a dopamine def. all my life, it was making me depressed. Does that make sense?
Posted by floatingbridge on November 6, 2009, at 18:28:32
In reply to Re: Starting two week wash out...I'm scared!!!, posted by Monica L on November 6, 2009, at 18:12:33
Hi Monica,
Can't address the dopamine issue (though I sense I'm in the same boat)--I wanted to say that I'm glad you're feeling alright. Yay! Maybe this won't be so hard or scarey after all. :-)
warmly,
fb
Posted by Phillipa on November 6, 2009, at 20:16:17
In reply to Re: Starting two week wash out...I'm scared!!!, posted by Monica L on November 6, 2009, at 18:12:33
Monica paxil should not be withdrawn all of a sudden what dose? Should be tappered and still don't know why you need a washout period for EMSAM as if starting on 6mg no restrictions on food or anything. It's only the higher 9 And 12mg that the tyramine is involved. Phillipa
Posted by Phillipa on November 6, 2009, at 20:18:52
In reply to Re: Starting two week wash out...I'm scared!!! » Phillipa, posted by floatingbridge on November 6, 2009, at 17:58:45
fb me also and unless the dx has changed no to the best of my knowledge. Love Phillipa
Posted by floatingbridge on November 6, 2009, at 20:25:20
In reply to Re: Starting two week wash out...I'm scared!!! » Monica L, posted by Phillipa on November 6, 2009, at 20:16:17
> Monica paxil should not be withdrawn all of a sudden what dose? Should be tappered and still don't know why you need a washout period for EMSAM as if starting on 6mg no restrictions on food or anything. It's only the higher 9 And 12mg that the tyramine is involved. Phillipa
Phillipa,
My understanding is that even at 6mg a washout is necessary for emsam unless it is the most dire of circumstances, and then it should be monitored very closely. My doctor wanted to do a three week washout. Yikes! Hopefully we can shorten that to two.
fb
Posted by Phillipa on November 6, 2009, at 21:24:18
In reply to Re: Starting two week wash out...I'm scared!!! » Phillipa, posted by floatingbridge on November 6, 2009, at 20:25:20
Seriously as when I was going to try it was no washout period. Just start it? Three weeks? Still you have to taper off the paxil. Love Phillipa
Posted by Maxime on November 7, 2009, at 12:23:32
In reply to Re: Starting two week wash out...I'm scared!!! » Phillipa, posted by floatingbridge on November 6, 2009, at 20:25:20
FB, two weeks should be enough of a washout for you. I did three for Parnate but only because I was away on holiday.
Posted by floatingbridge on November 7, 2009, at 18:47:36
In reply to Re: Starting two week wash out...I'm scared!!! » floatingbridge, posted by Maxime on November 7, 2009, at 12:23:32
Glad to hear from you two that I can do a two week washout. I'll push for that (heavily).
Phillipa, why taper on paxil? Discomfort? Seizure risk?
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Posted by floatingbridge on November 7, 2009, at 18:48:41
In reply to Re: Starting two week wash out...I'm scared!!! » floatingbridge, posted by Maxime on November 7, 2009, at 12:23:32
Hi Monica,
I was thinking of you today and wondering how it is going for you.
fb
Posted by Phillipa on November 7, 2009, at 19:00:24
In reply to Maxime + Phillipa--washout » Maxime, posted by floatingbridge on November 7, 2009, at 18:47:36
Fb brain zaps were horrible for me. Your turn your head and it's almost like blacking out for a tiny second. Love Phillipa
Posted by Maxime on November 7, 2009, at 19:41:00
In reply to Re: Maxime + Phillipa--washout » floatingbridge, posted by Phillipa on November 7, 2009, at 19:00:24
Yes, Paxil is one of the harder SSRIs to come off I believe. Very bad withdrawal. But maybe things will be different for Monica which would be nice.
Posted by Phillipa on November 7, 2009, at 20:04:27
In reply to Re: Maxime + Phillipa--washout » Phillipa, posted by Maxime on November 7, 2009, at 19:41:00
Well I was on a low dose and it wasn't that hard as long as bit a piece off slowly cutting down each day. How high is her dose. Monica sorry to talk around you. Love Phillipa
Posted by Maxime on November 8, 2009, at 10:42:14
In reply to Re: Maxime + Phillipa--washout » Maxime, posted by Phillipa on November 7, 2009, at 20:04:27
Hi Monica, I was just wondering how you are doing and if you have any withdrawal symptoms yet. I hope not! Take care.
Posted by Monica L on November 8, 2009, at 14:56:51
In reply to Monica, posted by Maxime on November 8, 2009, at 10:42:14
Hey everyone, I've been doing good so far, no withdrawl effects! The last dose of Paxil I took was last weds and it was 40 mg...I did taper completely off the buspar and just stopped the ritalin last thurs as well. I'm still not feeling to great mentally, just wanting to lay around mostly. I've been having some really long interesting dreams though. But physically no withdrawl effects so far!! I'm counting down the days till I start the EMSAM. I've read a lot of older post from people who've been on it and are still going strong on it, it's really good to read that. Thanks so much for keeping in touch with me, you guys are a great source of support!!
Have a great rest of the weekend!!
Posted by Phillipa on November 8, 2009, at 19:19:28
In reply to Re: Monica, posted by Monica L on November 8, 2009, at 14:56:51
Monica that's sensational. One med I really wanted to try. Pdoc said no. Ickkk. Phillipa
Posted by maxime on November 9, 2009, at 7:43:27
In reply to Re: Monica, posted by Monica L on November 8, 2009, at 14:56:51
That's great news! I hope it keeps up! EMSAM is just around the corner for you.
This is the end of the thread.
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