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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ihatedrugs1 on September 16, 2014, at 20:28:18
Hello all,
I've finally mustered some energy to write after being bed-ridden the last few days. So my dr. put me on the Emsam patch at my request after being on a combination of Lexapro, Abilify, Vyvanse and Adderall (if needed). I wanted to see if I could achieve similar therapeutic effects without the horrible crash I get from Vyvanse and Adderall. I'm now taking 12mg/24hr Emsam after wash out period (went up to 12 in four days) 250mg of Nuvigil and 5 mg Saphris.
I know I have to give Emsam more time but after 10 days I am feeling horrible. Nuvigil or Provigil are doing nothing for my energy. I have zero motivation (which I used to get from Vyvanse or Adderall) and feel like crying every day (even though my meds prevent me from doing so). Saphris which was switched from Abilify gives me a bad case of restless legs syndrome so I have to take Cogentin for it, but it seems to improve my mood somewhat (or it may be the Emsam) though short lived. The doctor said I could go back to Abilify if I needed to, but it gives me a feeling of overall restlessness that I hate, though it helps some of my depressive symptoms.
I'm wondering if I should go back on the old regime and live with the amphetamine crashes and partial depression relief or stick it out a couple of more weeks for the Emsam to work and see if it resolves my lack of motivation and disinterest. I don't have ADD but amphetamines helped me greatly with motivation. I feel that if I get a robust enough antidepressant effect from Emsam, I could go back at being my happy old self without the need of daily amphetamine use.
I asked my dr. if I could add a tiny bit of adderall (5mg)to my cocktail just to help me with running errands and get somethings done but she said that it was contraindicated. I wonder if she is just being super cautious.
Does anyone in this forum know if I could take a small (5mg) amount of adderall with Emsam? I don't mean every day but just those where I have to go somewhere. I have a blood pressure cuff and my readings are perfect. What do you guys think? Also, is anyone here on the patch or were on the patch? Is it worth it or is it another useless AD. If you are on the patch or were; how long did it take for you to see improvement.
I'm desperate because I'm going on a trip at the end of October and need to be feeling better.ihatedrugs
MDD Refractory
meds before change
Lexapro 20mg
Abilify 4mg
Vyvanse40mg
Adderall as needed
Xanax
Ambien
Deplinmeds now
Emsam 12
Saphris 5
Provigil 200 or Nuvigil 250
Xanax
Ambien
Cogentin
Deplin
Posted by Beckett on September 17, 2014, at 16:12:11
In reply to Anyone on Emsam Patch Help?, posted by ihatedrugs1 on September 16, 2014, at 20:28:18
Hey there, I'm sorry to hear that you haven't been doing better. Emsam was most energizing at 9 mg.
I understand the desire to feel well for vacation.
I'm curious the reasons for going from 9 to 12 in a few days. (If I read that correctly.)
Posted by ihatedrugs1 on September 17, 2014, at 17:40:17
In reply to Re: Anyone on Emsam Patch Help?, posted by Beckett on September 17, 2014, at 16:12:11
Hello Becket,
Thanks for your reply. My Pdoc raised the dose after only 3 days of taking 6mg. My husband called her to ask about continuing Adderall at small doses, but she said no to that. She told him to to raise the dosage to the full 12mg by putting 2 patches on. I thought it was rather odd to titrate so drastically but I'm so desperate to feel well, I figured the higher the dose the better the outcome. I have been on the 12mg now around 10 days and aside from a little anxiety, I have not felt anything too worrisome.
I really hope she knows what she is doing. I've been her patient for over 10 years.
I'm so new to Maoi's and only know not to eat high tyramine foods and watch my blood pressure. I'm a little worried about all the possible interactions with other meds.
I have an appointment with another doctor to look into Deep tms as a possible option. I did 6 weeks of Rtms and felt about 60% better, though $12,000 poorer (insurance coverage is under appeal at this time).
My problem is I think I'm never going to feel better and become desperate. The fatigue, disinterest and lack of motivation make me feel so useless. That is why I liked Adderall and Vyvanse because they gave me energy and motivation, even if for a few hours; but I was becoming too dependent on them and the crash in the afternoon was killing me.
How did you fare with Emsam? For what I've read, I don't think too many people are on it.Hope you're well,
ihatedrugs
Posted by Phillipa on September 17, 2014, at 22:04:29
In reply to Re: Anyone on Emsam Patch Help? » Beckett, posted by ihatedrugs1 on September 17, 2014, at 17:40:17
I think a lot of why is the price. Go to Archieves And Robert Davis Did really well on it. And sometimes if you babblemail him he will write back. Phillipa
Posted by ihatedrugs1 on September 18, 2014, at 20:44:19
In reply to Re: Anyone on Emsam Patch Help? » ihatedrugs1, posted by Phillipa on September 17, 2014, at 22:04:29
> I think a lot of why is the price. Go to Archieves And Robert Davis Did really well on it. And sometimes if you babblemail him he will write back. Phillipa
Thanks Phillipa, I will check the archives.
Be well,
ihatedrugs
Posted by Beckett on September 18, 2014, at 23:05:36
In reply to Re: Anyone on Emsam Patch Help? » Phillipa, posted by ihatedrugs1 on September 18, 2014, at 20:44:19
Ihd, thinking back, I had an immediate up from emsam at 6 mg which wasn't quite sustainable. 12 mg caused dizziness, so I went back to 9 mg. I think it took about a month to settle in. I went off to restart tramadol, the best medication I'd found for neuropathy.
Posted by ihatedrugs1 on September 19, 2014, at 13:22:44
In reply to Re: Anyone on Emsam Patch Help?, posted by Beckett on September 18, 2014, at 23:05:36
> Ihd, thinking back, I had an immediate up from emsam at 6 mg which wasn't quite sustainable. 12 mg caused dizziness, so I went back to 9 mg. I think it took about a month to settle in. I went off to restart tramadol, the best medication I'd found for neuropathy.
>
>
Thanks B,
I hope Emsam @12mg works for my stubborn depression and fatigue.Be well
ihatedrugs
Posted by Beckett on September 19, 2014, at 14:53:23
In reply to Re: Anyone on Emsam Patch Help?, posted by ihatedrugs1 on September 19, 2014, at 13:22:44
Posted by ihatedrugs1 on September 19, 2014, at 15:14:53
In reply to Good thoughts your way. Let us know, will you? (nm) » ihatedrugs1, posted by Beckett on September 19, 2014, at 14:53:23
Posted by Beckett on September 24, 2014, at 18:38:51
In reply to Re: Let us know, will you? Will do. (nm) » Beckett, posted by ihatedrugs1 on September 19, 2014, at 15:14:53
Posted by ihatedrugs1 on September 27, 2014, at 19:16:47
In reply to hey, how goes it? (nm) » ihatedrugs1, posted by Beckett on September 24, 2014, at 18:38:51
Hi Beckett,
Thanks for asking. I gave up on Emsam at three weeks @ 12mg (last Thursday). I know it deserved more time but I was not feeling any different, perhaps less weepy, and running out of time. Shouldn't have planned a meds change so close to a vacation trip. Now, I have to wait at least a week to go back on Lexapro (Serotonin Syndrome). That gives me 3 weeks before I go on vacation. Hopefully, it will kick in by then. I ditched the Saphris and went back on Abilify 5mg. I also started Lamictal (3 days) but I'm not so sure it's such a great idea. I took it once and can only recall marginal relief; maybe shouldn't rock the boat with so little time to resolve this depression.
I have just made a mess of things. Right now I'm at such a low point and afraid I won't get some relief in time. My pdoc is useless as she is out of ideas and I'm the one suggesting meds.
I do have an appointment on the 6th for a consult on deep tms. I partially responded to rtms so I'm hopeful it may bring some relief faster and before 10/26 (day I leave). Otherwise, it'll be a sorry Caribbean vacation.
I'm so tired and consumed by this illness; can't even think straight. I don't even remember how feeling well feels like.Hope you are doing well,
ihatedrugs
Posted by former poster on October 8, 2014, at 22:38:01
In reply to Anyone on Emsam Patch Help?, posted by ihatedrugs1 on September 16, 2014, at 20:28:18
I'm on Emsam 6mg patch now. MAOI's take quite a while to kick in. Emsam can be deceiving because the stimulant effect is so powerful and is not the real therapeutic effect.
This is the end of the thread.
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