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Re: Grrr... EMSAM again, what to expect? » Racer

Posted by Brody on October 13, 2007, at 13:56:25

In reply to Grrr... EMSAM again, what to expect?, posted by Racer on October 13, 2007, at 0:00:37

Hi Racer,

I've been on Emsam since May '07. I'll answer your specific questions below, but a general comment is that I have noticed increased benefits and lessening of side effects continually for the entire 5 months.

> my fear of giving up Concerta and Wellbutrin, ................... It looks far bleaker than it probably is.>>


So it sounds as though you are prepared for the washout period you may experience going off of these meds? I, too, had been on Wellbutrin (450mg and augmented with Abilify) before going on Emsam. The washout was not pleasant.... It will be helpful if you can remember that last sentence you wrote above....


>
> can anyone tell me anything about whether to expect brain fog or sedation?>>

Brain Fog: I experienced the reverse. "Hello? Did someone turn the lights on?".

Sedation: After about 8 weeks, I did begin to experience some afternoon somnolence, and my p-doc has since added Provigil. I take only 50 mg, and after reading D0pamine posts, I now take it on an as needed basis.... less often all the time.... 2 to 3 times per week.

Perhaps the less frequent need to augment with Provigil is due to the accumulative nature of EMSAM's effects.... the energy boosting mechanisim that wasn't there for me initially seems to have kicked in.


>> What about apathy?>>

I am taking more pleasure in everyday things and I have much more interest in those around me.

For me, EMSAM was the tool that lifted the DEPRESSION, and it did so in a big way. BUT, again, I did not get the initial boost in energy that many users have reported. I now am able to tackle and work through large complicated tasks, and I attribute that to the med combo, and the addition of CBT.

>>Hypotension?>> If you did have trouble with it, is your normal blood pressure low/high/perfect range?

Oh Boy! This was a big problem for me. My normal blood pressure has always been low, say around 110/60. I had orthostatic hypotension with EMSAM at 6mg and 9mg, and I was falling on the floor at 12mg. (My p-doc was very agressive with dosing EMSAM, I think because my depression was bordering on crisis and she didn't feel like waiting around. Hindsight, she maybe went too fast, but dropping the dose has worked out fine.)

We tried Florinef to raise BP but I didn't like side effects... too much water retention. After dropping back to 9mg Emsam, I just dealt with the hypotension, and it has lessened over time. I rarely notice it anymore and my BP has actually gone up a little. Unfortunately, so has my pulse rate.

>
>And, of course, weight gain? If so, has that been a problem for you with other drugs?
>
>

I will agree 100% with D0pamine here. The carb cravings are something to behold! Having this info in advance..... maybe you can stay disciplined... DON'T GO ANYWHERE NEAR CHOCOLATE! I now have to deal with a 10 pound weight gain!
Is this your first MAOI? It is mine, and I have not experienced a med related weight gain before. Quite terrifying!


Best of luck to you, Racer.

If you can... please give this med a good LONG trial.

P.S. You didn't ask about anxiety. Let me know if you want my input on that.


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poster:Brody thread:788878
URL: http://www.dr-bob.org/babble/20071009/msgs/788974.html