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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by LucidDreamer on December 2, 2012, at 1:55:40
Hi everyone. I was wondering if the Emsam patch is more effective than SSRIs (much like how other MAOIs which require dietary restrictions are). I know that Emsam is usually not as effective as other regular MAOIs, but was wondering if it's still somehwat better than SSRIs. Also for the poeple that have used this patch, how was your experience? How much did it help with depression and anxiety? Right now I have crippling anxiety and pretty bad depression. I'm looking for something that to help with both, but my main concern is anxiety. I've done some research on Emsam and have found that most people don't see improvement in their anxiety. I'm particularly curious if anyone here has had any success with Emsam in terms of anxiety. Any help is greatly appreciated. Thank you!
Posted by bleauberry on December 2, 2012, at 5:28:38
In reply to Is the Emsam patch more effective than SSRIs?, posted by LucidDreamer on December 2, 2012, at 1:55:40
No it is not. I have not seen it more effective either scientifically or anecdotally. Actually, I can't think of a single person here over the years that found it to be their magic med.
If you are thinking along the lines of mao inhibitors, forget ensam, go for the real ones. Parnate first, Nardil second.
Or to make a ssri work better, add a norepinephrine component to it, such as nortriptyline, desipramine, ritalin, focalin, or savella.
Posted by SLS on December 2, 2012, at 6:51:24
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by bleauberry on December 2, 2012, at 5:28:38
> No it is not. I have not seen it more effective either scientifically or anecdotally. Actually, I can't think of a single person here over the years that found it to be their magic med.
>
> If you are thinking along the lines of mao inhibitors, forget ensam, go for the real ones. Parnate first, Nardil second.
>
> Or to make a ssri work better, add a norepinephrine component to it, such as nortriptyline, desipramine, ritalin, focalin, or savella.I would urge that one not add Savella (milnacipran) to an MAOI. It is too potent as a serotonin reuptake inhibitor, and will very likely produce serotonin syndrome.
I am sure that this was just an oversight by Bleauberry.
- Scott
Posted by Phillipa on December 2, 2012, at 9:03:04
In reply to Is the Emsam patch more effective than SSRIs?, posted by LucidDreamer on December 2, 2012, at 1:55:40
I think the poster Willful is now taking emsam as has for a while. So for this poster it must work. Could start a thread asking for a reply from Willful. Also the archieves used to have a good number of posters who used emsam. I always like the idea of a patch you could see. I do know that one poster in particular had good results using it with klonopin for anxiety. That poster is Robert David. Phillipa
Posted by LucidDreamer on December 2, 2012, at 19:30:42
In reply to Re: Is the Emsam patch more effective than SSRIs? » LucidDreamer, posted by Phillipa on December 2, 2012, at 9:03:04
> I think the poster Willful is now taking emsam as has for a while. So for this poster it must work. Could start a thread asking for a reply from Willful. Also the archieves used to have a good number of posters who used emsam. I always like the idea of a patch you could see. I do know that one poster in particular had good results using it with klonopin for anxiety. That poster is Robert David. Phillipa
Thank you so much.
Posted by Phillipa on December 2, 2012, at 22:52:31
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by LucidDreamer on December 2, 2012, at 19:30:42
Your welcome Phillipa
Posted by jono_in_adelaide on December 3, 2012, at 19:19:26
In reply to Is the Emsam patch more effective than SSRIs?, posted by LucidDreamer on December 2, 2012, at 1:55:40
I think in general, emsam is about equal to the general bog standard of antidepressants, its advantage is that it works in a different way to the SSRI's, so if you fail an SSRI somthing with a different mode of action might work.
I wouldnt say its "better", just different
Posted by Willful on December 3, 2012, at 21:35:20
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by SLS on December 2, 2012, at 6:51:24
As Phillipa said, I've been taking emsam since it first came out, and it's worked extremely well for me, both for anxiety and depression.
I would say that initially your anxiety could increase, but that as you accommodate to it, this diminishes. I couldn't say 100% whether my anxiety wasn't related to being depressed, but both of them are much much better than previously. I think I began with emsam and a very small amount of abilify and provigil (to help with issues of not sleeping). Later I added rilutek, which is a rather non-standard med, which happens to work extremely well for me.
I recommend trying emsam, if you're interested, because the food interactions only become problematic at quite high doses, although the med interactions are the same as all MAOIs. I started with parnate and ran into a serious complication with it, after which I used cymbalta for a time, which didn't work much for me.
SSRIs really disagree with me-- the relative merits really depend on individual reactions. But I think MAOIs are extremely good drugs and should be much higher up on the list of meds to try.
But this may be a minority opinion. I know emsam is expensive, which may be partly responsible for its rarity in use. But if your insurance will pay for it, I would definitely recommend it.
Posted by Phillipa on December 3, 2012, at 22:00:25
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by Willful on December 3, 2012, at 21:35:20
Willful so glad you replied. So the price still hasn't gone down? That was the big drawback for many when released. I think a lot more success stories if It had been less expensive. Still like the idea of a patch. So glad it's working well for you. And for a while congrats!!! Phillipa
Posted by LucidDreamer on December 4, 2012, at 1:26:02
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by Willful on December 3, 2012, at 21:35:20
> As Phillipa said, I've been taking emsam since it first came out, and it's worked extremely well for me, both for anxiety and depression.
>
> I would say that initially your anxiety could increase, but that as you accommodate to it, this diminishes. I couldn't say 100% whether my anxiety wasn't related to being depressed, but both of them are much much better than previously. I think I began with emsam and a very small amount of abilify and provigil (to help with issues of not sleeping). Later I added rilutek, which is a rather non-standard med, which happens to work extremely well for me.
>
> I recommend trying emsam, if you're interested, because the food interactions only become problematic at quite high doses, although the med interactions are the same as all MAOIs. I started with parnate and ran into a serious complication with it, after which I used cymbalta for a time, which didn't work much for me.
>
> SSRIs really disagree with me-- the relative merits really depend on individual reactions. But I think MAOIs are extremely good drugs and should be much higher up on the list of meds to try.
>
> But this may be a minority opinion. I know emsam is expensive, which may be partly responsible for its rarity in use. But if your insurance will pay for it, I would definitely recommend it.
>
>
Thank you so much Willful for replying. I now have more hope that it will help my anxiety. I too take Abilify and that has helped with my anxiety, while most people complain of worsened anxiety when taking it. That has given me more hope that Emsam will help my anxiety. Because both of these meds affect dopamine and in my case some of my anxiety is related to dopamine. Also did you experience any side effects while on Rilutek? Thanks.
Posted by Willful on December 4, 2012, at 10:13:56
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by LucidDreamer on December 4, 2012, at 1:26:02
Hi Lucid dreamer,
I haven't noticed any side effects at all with rilutek. That, very clearly, helped with anxiety actually. I hesitated to mention that because it is so unusual to see anyone taking it. For one thing, it's a quite expensive med. It may not help that many people, or because of expense hasn't caught on. But I found it very effective. I just have found myself feeling much better with it than not.
However, my pdoc says this is a very unusual and maybe for not something he would do much. It works so well for me- however-- that he's okay with it. I think he;s particularly worried about the abilify though because a reaction I had once to another med. I could be wrong, but I think that's part of his concern. You could ask your pdoc about it though and see what s/he says.
Posted by AlexCanada on December 4, 2012, at 18:28:38
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by Willful on December 4, 2012, at 10:13:56
I am on day 25 of Selegiline Oral. I started 7.5mg for around 19 days and 6 days raised to 10mg. I'm normally sensitive to meds but I have not felt much from it aside from mild hypotension which is eased with ginkgo biloba.I been taking it along with low dose ritalin,+ valium for severe melancholic depression.
my symptoms are lack of emotions, inability to enjoy things, poor drive/motivation, difficulty thinking, poor memory, low energy, apathy.
I also take Royal Jelly 3000mg a day + around 420mg gingko biloba (helps a bit for memory).
Anxiety is not an issue for me. All the melancholic depressive issues are.
SSRIs tend to numb me out, and make me feel even more intellectually + emotionally compromised than I already am.
Is there hope for me with Selegiline? I been considering raising the dose. I still feel extremely bland most of the time. Mind feels very closed off and I'm very non social too.
At what dose does Selegiline start to function for Seratonin? I do feel I need a seratonin component to my mix but I tried too many SSRIs (paxil worked but pooped out) and almost all made me feel worse. I've tried endles meds and Gabapentin makes me feel slightly alive but it's effect never lasts. Gabapentin works on Seratonin + gluta.
Need advice or possible alternatives. Even herbal/suppliments...
Posted by LucidDreamer on December 4, 2012, at 20:24:12
In reply to Need Selegiline / Emsam advice » Willful, posted by AlexCanada on December 4, 2012, at 18:28:38
>
> I am on day 25 of Selegiline Oral. I started 7.5mg for around 19 days and 6 days raised to 10mg. I'm normally sensitive to meds but I have not felt much from it aside from mild hypotension which is eased with ginkgo biloba.
>
> I been taking it along with low dose ritalin,+ valium for severe melancholic depression.
>
> my symptoms are lack of emotions, inability to enjoy things, poor drive/motivation, difficulty thinking, poor memory, low energy, apathy.
>
> I also take Royal Jelly 3000mg a day + around 420mg gingko biloba (helps a bit for memory).
>
> Anxiety is not an issue for me. All the melancholic depressive issues are.
>
> SSRIs tend to numb me out, and make me feel even more intellectually + emotionally compromised than I already am.
>
> Is there hope for me with Selegiline? I been considering raising the dose. I still feel extremely bland most of the time. Mind feels very closed off and I'm very non social too.
>
> At what dose does Selegiline start to function for Seratonin? I do feel I need a seratonin component to my mix but I tried too many SSRIs (paxil worked but pooped out) and almost all made me feel worse. I've tried endles meds and Gabapentin makes me feel slightly alive but it's effect never lasts. Gabapentin works on Seratonin + gluta.
>
> Need advice or possible alternatives. Even herbal/suppliments...
>
>
The symptoms you describe accurately describe what I've been going through for over a year + crippling anxiety. I'm basically in the same boat. Like I have virtually no motivation, very little energy, I can't enjoy things, my memory is suffering big time, etc. I too have experienced bad emotional numbness that only made things worse for me with SSRIs(although remember there very well may be an SSRI out there that won't make you numb). There's always a chance that a medication could help you(in some cases they could turn out to be MUCH more effective than you previously thought), and the only way to know if a medication is going to help you or not is to be as patient as you can, and give it sufficient time. I don't know what the full dosage for Selegiline is, but if you feel like 10 mg is just not cutting it for you, talk with your doctor and see if you can increase the dosage. I have read somewhere that the Emsam patch (I know you're using the oral form-Selegiline, but I'm pretty sure they're the same thing) works on Serotonin definately at 12 mg. To be sure I would ask your doctor about Selegiline and Serotonin. My best suggestion is to first see if an increased dosage of Selegiline helps you (should you and your doctor decide to increase it), and if that doesn't help, you can ask your doctor about Parnate. I have heard wonderful things about this med. Do a google search on it and you'll see. The only thing with it, is that as you already know, just like Selegiline you have to follow medication and dietary restrictions. Definitely talk to your doctor about it. And always remember, no matter how dark and painful things may get, there's always hope and happiness somewhere to be found deep within yourself to help you get through this. There are A LOT of medications out there, and in most cases there's always at least one that will provide you with the relief that you need to beat depression. Oh and in case you haven't already, tell your doctor about the supplements you are taking to make sure there are no interactions with Selegiline. The OTC things that come to mind that can help depression are 5HTP and ST. John's Wort, but DO NOT take them with Selegiline, because it is not safe as far as I know. Also remember, medications can only help so much. Also make sure you are exercising whenever you think you can, and eat as healthy and as nutritional as you can. And I know I have read elsewhere that Fish oil can help with depression a little, so you can try that, it wouldn't hurt(just make sure it is a good and reputable brand). Also there's something called Suntheanine that may help increase dopamine, which in turn may help you be able to enjoy things a little more. Definitely do a google search on that as well. I'm pretty sure it's safe to take with an MAOI(read about others taking it with an MAOI), but ask you doctor about it to be on the safe side. Sorry I don't have more suggestions as far as alternatives go. The best natural medication for depression, is exercising, and being around people you love. Oh and talking about your problems with a good listener can help out A LOT also. I sincerely wish you make a full recovery, having come out on the other side stronger than you've ever been. You are not alone. Best wishes, peace.
Posted by bleauberry on December 5, 2012, at 14:31:05
In reply to Re: Is the Emsam patch more effective than SSRIs?, posted by SLS on December 2, 2012, at 6:51:24
Scott I was talking about adding these to ssri, not maoi.....
> > Or to make a ssri work better, add a norepinephrine component to it, such as nortriptyline, desipramine, ritalin, focalin, or savella.
>
> I would urge that one not add Savella (milnacipran) to an MAOI. It is too potent as a serotonin reuptake inhibitor, and will very likely produce serotonin syndrome.
>
> I am sure that this was just an oversight by Bleauberry.
>
>
> - Scott
Posted by SLS on December 5, 2012, at 16:18:10
In reply to Re: Is the Emsam patch more effective than SSRIs? » SLS, posted by bleauberry on December 5, 2012, at 14:31:05
Oops.
I apologize.
- Scott>
>
> Scott I was talking about adding these to ssri, not maoi.....
>
> > > Or to make a ssri work better, add a norepinephrine component to it, such as nortriptyline, desipramine, ritalin, focalin, or savella.
>
>
> >
> > I would urge that one not add Savella (milnacipran) to an MAOI. It is too potent as a serotonin reuptake inhibitor, and will very likely produce serotonin syndrome.
> >
> > I am sure that this was just an oversight by Bleauberry.
> >
> >
> > - Scott
>
>
This is the end of the thread.
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