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Dr. Bob is Robert Hsiung, MD,
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Posted by hyperfocus on May 25, 2011, at 23:38:00
In reply to Help, please. Does EMSAM ever work for anxiety, posted by Lepus on May 22, 2011, at 2:56:03
Hey could you describe your condition some more? What type of anxiety specifically did you have when it became noticeable - was it like social anxiety or one of the phobias or generalized? Have you had an official diagnosis? It's possible that you have some serious condition besides just the anxiety.
Anxiety stuff tends to get worse, unfortunately, if left untreated for a long time. Whatever your original condition was,its possibly morphed into something else that also needs proper treatment. Depression and dissociation can result from long-term anxiety conditions, plus a whole host of psychological maladies like BDD that you might need to spend time with a therapist repairing. But in my totally layman's assessment MAOIs are a good start for what you might have. You might find as your depression level goes down, the anxiety and everything else gets better. So I'd say stick with the EMSAM. It seems to work in the majority of cases for those who can tolerate it. If you can tolerate it and have even a partial response then you coud look with hope towards Nardil or Parnate. Atypical APs like Risperdal and Abilify and Zyprexa and Seroquel could also help a lot in the future. Benzos aren't a great long-term option but if you're in a lot of pain and non-functional they do have their role for short-term acute relief. Your doctor should know that anxiety sufferers cannot become emotionally dependent on benzos.
I'm in a sort of similar position where my mind seems uncontrollable and loves to build these gigantic black cathedrals of despair every day and all I can do is gaze at them when everything I want to do in life gets neglected. It can be scary and demoralizing, especially if it's gone on for a long time but there is hope. I'm in my thirties also but I believe I've started the long process of getting better, thanks to this site. I think that right now even with the ambiguous state of psychiatry there exists enough information and tools to help you. As long as you're willing to research you own treatment you will eventually find what you're looking for. That's what I believe anyway. I wish you the best.
Posted by SLS on May 26, 2011, at 5:26:46
In reply to Re: Help, please. Does EMSAM ever work for anxiety » Lepus, posted by hyperfocus on May 25, 2011, at 23:38:00
What a great post, Hyperfocus. You hit the target on everything.
"gigantic black cathedrals of despair"
Powerful verbiage.
- Scott
> Hey could you describe your condition some more? What type of anxiety specifically did you have when it became noticeable - was it like social anxiety or one of the phobias or generalized? Have you had an official diagnosis? It's possible that you have some serious condition besides just the anxiety.
>
> Anxiety stuff tends to get worse, unfortunately, if left untreated for a long time. Whatever your original condition was,its possibly morphed into something else that also needs proper treatment. Depression and dissociation can result from long-term anxiety conditions, plus a whole host of psychological maladies like BDD that you might need to spend time with a therapist repairing. But in my totally layman's assessment MAOIs are a good start for what you might have. You might find as your depression level goes down, the anxiety and everything else gets better. So I'd say stick with the EMSAM. It seems to work in the majority of cases for those who can tolerate it. If you can tolerate it and have even a partial response then you coud look with hope towards Nardil or Parnate. Atypical APs like Risperdal and Abilify and Zyprexa and Seroquel could also help a lot in the future. Benzos aren't a great long-term option but if you're in a lot of pain and non-functional they do have their role for short-term acute relief. Your doctor should know that anxiety sufferers cannot become emotionally dependent on benzos.
>
> I'm in a sort of similar position where my mind seems uncontrollable and loves to build these gigantic black cathedrals of despair every day and all I can do is gaze at them when everything I want to do in life gets neglected. It can be scary and demoralizing, especially if it's gone on for a long time but there is hope. I'm in my thirties also but I believe I've started the long process of getting better, thanks to this site. I think that right now even with the ambiguous state of psychiatry there exists enough information and tools to help you. As long as you're willing to research you own treatment you will eventually find what you're looking for. That's what I believe anyway. I wish you the best.
Posted by lepus on May 27, 2011, at 13:52:02
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by SLS on May 25, 2011, at 6:42:15
Hi Scott,
My condition is MDD and severe panic attacks with agoraphobia. The panic attacks seem to be the worst symptom although depression is very bad right now. I'm just so frustrated and lost. For instance, I should really be hospitalized to get this mess straightened out but apparently unless you are suicidal or homicidal you will not be hospitalized.
What a crock.
Anyway, is there any evidence of low dose EMSAM working for panic disorder? I really don't see much evidence on the 'Net.
Posted by lepus on May 27, 2011, at 13:54:55
In reply to Re: Does EMSAM ever work for anxiety, posted by floatingbridge on May 25, 2011, at 12:33:08
Thanks for the information, FB. It's very helpful. I'm still talking to my pdoc about what to start or when. I'm thinking I might give Seroquel XR a trial first.
I just don't know. I know I can't tolerate anymore anxiety yet I'm so depressed I don't feel like I can do anything. I have no energy. Has that ever happened to anyone else? All you want to do is sleep all day and you feel so tired that you think you could slip into a coma?
Posted by lepus on May 27, 2011, at 14:02:05
In reply to Re: Help, please. Does EMSAM ever work for anxiety » Lepus, posted by hyperfocus on May 25, 2011, at 23:38:00
> Hey could you describe your condition some more? What type of anxiety specifically did you have when it became noticeable - was it like social anxiety or one of the phobias or generalized? Have you had an official diagnosis? It's possible that you have some serious condition besides just the anxiety.
I started having panic attacks at age 12. Just came out of nowhere. I believe it was related to puberty. I had panic attacks away from my home. Imipramine pulled me out of that terror and worked well for many years.
Right now I believe my last diagnosis was MDD and panic disorder with agoraphobia. I used to just have panic attacks away from the home but now I seem to be in a constant state of anxiety. As for any other medical conditions, I was in the beginning stages of being treated for psoriatic arthritis before the agoraphobia really kicked in and I could no longer make the trips to my doctor. I recently had my appendix removed also. But I've had bloodwork and been seen by many doctors and nothing physical comes up in the tests. If I have some other medical illness it is something rare and not easily detectable. Frankly, I keep thinking this is more than just anxiety because of how tired I am but no doctor has found anything.
I just want to be admitted to a hospital for a full work up and to get stabilized. Doesn't appear that will happen though.
Thank you for your thoughts and for taking the time to reply.
Posted by floatingbridge on May 27, 2011, at 17:14:01
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 27, 2011, at 14:02:05
Lepus, I understand your hesitancy now to start a new med. Could you have a nurse visit you? Also, are there any university clinics in you area? Even if you needed to travel a bit to have confidence in someone overseeing what could be a delicate balancing act. I'm sorry you are facing such decisions.
I wanted to update you on my emsam experience. I'm tolerating it really well, which is surprising the jeepers out of my doctors. I feel more physical and mental energy. That's good. However....a big however, there is a core of anxiety it isn't addressing. My xanax usage has risen and I take Valium nightly for sleep. No one, including myself, is pleased with this part. Where this leads, I don't know.
Let me say it's working better, even the benzo use factored in, so far than my snri cocktail. Just being able to get out of bed is stress relief of sorts.
So, it's not a magic bullet for stress :(
It's not harming me :)
It has an actual AD effect :)
You might tolerate it well enough to be able to prove to both yourself and your doctor that you might tolerate Nardil.
Super good luck with this.
fb
Posted by lepus on May 27, 2011, at 18:46:37
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by floatingbridge on May 27, 2011, at 17:14:01
Is your anxiety the same since starting EMSAM or worse? You said you're using more benzos which seems like it is worse but I just want to clarify.
I could really use more physical and mental energy right now. I am so tired I can't even do my homework. I just can't think. I think I might have to drop out of school this semester.
Posted by Phillipa on May 27, 2011, at 21:20:18
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 27, 2011, at 14:02:05
My Mother had that and it's an autoimmune disease and sometimes they cluster possible you have another. I'd suggest seeing a Rheumatologist for a work up. So many autoimmune disorders manifest as phychological. Phillipa
Posted by floatingbridge on May 27, 2011, at 21:29:46
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 27, 2011, at 18:46:37
Gosh. Let's see. It's better. And I need to take more xanax to achieve the same effect. I am having less anxiety or panic attacks. But when I do, I need twice the benzo. Sorry I can't give you a straight answer :(
I don't know how this will ultimately shake out for me. But hey, I cleaned my son's room, prepared a very easy meal, went to a parent teacher conference, actually purchased groceries (I hadn't been able to go to the market in months.)
When I write this out, it sounds like progress.
Oh, I need to take something to sleep every single night. Right now Valium works. I can get 5-7 hours of sleep. Working on getting 8-9.
Hope this helps.
fb
Posted by Phillipa on May 27, 2011, at 21:38:11
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by floatingbridge on May 27, 2011, at 21:29:46
FB geez that is serious progress. Keep up the great work!!!! Phillipa
Posted by floatingbridge on May 27, 2011, at 22:20:14
In reply to Re: Help, please. Does EMSAM ever work for anxiety » floatingbridge, posted by Phillipa on May 27, 2011, at 21:38:11
Thanks Phillipa. It is improvement:) It could mean that tomorrow might be crummy. That's fibro. Buy I have always had good days/weeks and bad days/weeks before fibro. Today was a good day. Maybe tomorrow won't be too bad. Now that would be real progress :)
I am exhausted now. Hopefully sleep soon and long :)
fb
Posted by Phillipa on May 28, 2011, at 0:02:13
In reply to Re: Help, please. Does EMSAM ever work for anxiety » Phillipa, posted by floatingbridge on May 27, 2011, at 22:20:14
I do wonder if taking 3 200mg tabs of motrin for 24 hours and then the next day if you will have a great day like I did the time the dentist had me do this for immflammation? Phillipa
Posted by lepus on May 28, 2011, at 15:00:25
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by Phillipa on May 27, 2011, at 21:20:18
I suppose that is always a possibility. My bloodwork always comes back negative for everything though. Even psoriatic arthritis doesn't show up in bloodwork that often. I lucked out because she was the first doctor to really examine me. She noticed the psoriasis on my hands, the pitted nails, etc. I wish I could beat this agoraphobia and get back to see her. She'll probably be retired by then...
Posted by lepus on May 28, 2011, at 15:03:29
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by floatingbridge on May 27, 2011, at 21:29:46
So you are having fewer panic attacks but the attacks you have are more severe? Or the benzos just don't work as well on them? I wonder if the EMSAM works on some neurotransmitter that makes the benzos less effective.
Yes, FB, your post definitely sounds like progress! I have my fingers crossed you will continue to feel well!
Thanks for answering my questions.
Posted by Phillipa on May 28, 2011, at 21:28:28
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 28, 2011, at 15:00:25
Yes those are signs of psoriasis pitting nail I also have been also test negative for rheumatoid arthritis no skin plaques. Aren't the two arthriti's basically the same? I must google if a rheumatoic factory is the method of diagnosis. Do you have joint swelling and pain? Phillipa
Posted by floatingbridge on May 28, 2011, at 21:55:32
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 28, 2011, at 15:03:29
Your welcome Lepus, anytime.
When might you give it a go?
You caught me reading about other maoi's. I am only 3 weeks in; yesterday was good. Today, bedrest all day :( .
When I read, I don't quite get it. Nardil with my anxiety seems the real ticket.
Maybe emsam will change if the dosage goes up, But it isn't really helping anxiety if it's causing rapid tolerance for xanax.
You got me at a low point :( I still feel emsam is a logically safe starting place. Maybe it will be all you need. I can hope. And if you see improvements, maybe Your doc Will release Nardil. I think it:s a safe try.
My apologies for the down tone. A day in bed is not fun unless I was Yoko Ono with John Lennon.
Good luck. I'll answer any question from you :-)
Posted by floatingbridge on May 30, 2011, at 2:14:28
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 28, 2011, at 15:03:29
I wanted to give you an update. A major portion of My anxiety may have been due to major hyperthyroidism. I just got the numbers tonight. A tsh of .05. I have hashimoto's and thought armour would be better than levoxyl. Well, nope.
I'll let you know of benzos regain efficacy, and insomnia lets go abit.
What are you doing these days? Have you started anything?
fb
Posted by lepus on May 30, 2011, at 19:16:10
In reply to lepus » lepus, posted by floatingbridge on May 30, 2011, at 2:14:28
Oh wow. Yes. That would make a lot of sense. Benzos aren't going to work very well on an overactive thyroid. Glad you found out you have that issue so you can correct it.
I haven't taken anything yet. At this point I think I've lost my mind. I'm so med-phobic. I'm terrified to try anything yet I'm sleeping all day and feel incredibly depressed. If I'm not spending my days fighting back horrible anxiety then I'm massively depressed. I know I need something but every drug scares me so much. I'm just tired and out of the strength to deal with this #@&* anymore.
Posted by lepus on May 30, 2011, at 19:19:22
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by Phillipa on May 28, 2011, at 21:28:28
RA and PA are similar but not the same. I think RA tends to be more severe. I do have joint swelling and pain. However, my symptoms are much better since I was diagnosed and treated for a Vitamin D deficiency. Who would have thought an agoraphobic would not be getting enough sunlight! :rolls eyes: My number was about a 5 when low normal is 30. Ridiculous.
Posted by lepus on May 30, 2011, at 19:21:04
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by floatingbridge on May 28, 2011, at 21:55:32
I'm sorry you had a down day, FB. I hope getting your thyroid corrected will help you immensely.
Posted by floatingbridge on May 30, 2011, at 19:29:36
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 30, 2011, at 19:21:04
It's ok Lepus, I've always had real cruumy days. I'm still here. Thanks.
I was thinking. An emsam trial stands between your nardil and your conservative doctor. Can someone deliver the emsam, even mail it? Just to get you started.
Cut it in thirds or quarters. After enough days, up it. If no side's (besides maybe anxiety) you'll be at 6mg.
How was your day?
Posted by lepus on May 30, 2011, at 20:45:59
In reply to Re: Help, please. Does EMSAM ever work for anxiety » lepus, posted by floatingbridge on May 30, 2011, at 19:29:36
I have the EMSAM here. So, it is ready for me to start it whenever I can get up the guts. I think I would feel better starting some Seroquel first. I don't know.
Today hasn't been a good day. Slept all afternoon. My anxiety has been low but my depression is very high. I'm so sleepy and can't concentrate. I'm supposed to take my accounting capstone course this summer and I don't see how I'm going to make it through. It starts Wednesday.
Posted by Phillipa on May 30, 2011, at 21:31:16
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 30, 2011, at 19:19:22
That is low my endo tested mine 2 years ago was 55 but they say up to 70 is fine and may be better. I googled the two arthritis's and I don't have either just the regular kind. I think I did read D was good for it. Since it's an autoimmune disease think you could have any undiagnosed? Phillipa
Posted by floatingbridge on May 30, 2011, at 21:52:50
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 30, 2011, at 20:45:59
Lepus,
Get up tomorrow, wash a small place on your body according to instructions and put your 1/4 or whatever patch on.
Honestly and please. If you could ever take seroquel (sorry, bad reaction to that here) or an ssri or snri, this was nothing. A non event. I was really scared. The box sat for two days before I (boldly) used 1/2 patch.
I felt not a thing much until the second day. Not horrible. I took some xanax. Now you know the real trouble was tsh.
I react to some really ordinary medicines. This, nothing--just avoid hot tubs Unless you want to have a dose surge :-/
Showers are just fine.
You could put the quarter patch on now. I had no sleep interference the first day.
Please. Good luck! Remember, if you freak out, and get anxious, take it off. Call your doc or just post.
You will most likely cake walk this.
Do you have a sleep med (seroquel) for when it '!hits' (48 hours on half patch for me)
fb
Posted by floatingbridge on May 31, 2011, at 12:48:05
In reply to Re: Help, please. Does EMSAM ever work for anxiety, posted by lepus on May 30, 2011, at 20:45:59
Just checking in with you today. Hope you are doing alright.
fb
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