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Dr. Bob is Robert Hsiung, MD,
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Posted by elkat on April 14, 2006, at 10:35:32
In reply to EMSAM-Day 5, posted by RobertDavid on April 12, 2006, at 9:53:45
Thanks for your reports. It sounds very interesting. It also sounds very expensive, and my HMO still considers Wellbutrin XL a "non-formulary" and doesn't provide the usual benefits for it, so it will probably be 2025 before EMSAM is covered, but I'm still very curious.
Posted by Last Chance on April 14, 2006, at 10:45:44
In reply to Re: Emsam Price/ Pulse » Last Chance, posted by pulse on April 14, 2006, at 1:55:32
Pulse - Oregon's health plan was once considered an example for the U.S. Now it is almost non-existent. There is no $$$$$ here, and you have to be pregnant or over 63 and pennyless for them to even accept an application. That is the sad reality about the OHP. About Costco and Emsam - the Pharmacist here said he showed no price, but that if I ordered it he could get it - if it was too expensive he said he would send it back. So now I'm waiting and expect it on Monday. He did make a guess, though - since it is $444.00 at my pharmacy, he said probably about $300.00. That would be better, of course, but I would still have to beg, borrow or STEAL! So we'll just have to wait and see. Richard
Posted by Last Chance on April 14, 2006, at 10:57:31
In reply to Re: Emsam Price/ Pulse, posted by Last Chance on April 14, 2006, at 10:45:44
There is a poster, NY Marine, on The Anxiety Community - he is on day 6 of Emsam, and says that he feels "agitated, anxious, nausea". Maybe it is not the miracle that some of us are hoping for. Richard
Posted by pulse on April 14, 2006, at 12:09:41
In reply to Re: pulse/GI stuff, posted by ravenstorm on April 14, 2006, at 8:29:40
ravenstorm,
thanks for your empathy/ sympathy. it's i that should feel for you - wow - NINE months on no AD/s. must be pretty to very tough! are you the one here who can no longer take even 2 mgs. prozac? prozac was my mainstay, but over the last 3 yrs. - i did best at only 10 mg - i've gotten closer and closer, then finally, to the point that the nausea just never quit - even at only 2.5 mgs., and, how much could that help (as a stand-alone AD)?
years ago, when i still went to/ believed in psychiatrists, i had one woman who was, at least, very med savvy and returned calls immediately, most always. she said she had another client, like me - that ADs making them sick in any way, and never relenting, made any gains they had/ were making with their depression, then, disappear.
i honestly don't feel like i could have hung in one more day. i've worked so hard these last 2-3 weeks at putting ALL things in motion to get the patch as early as possible, despite my being so very cognitively impaired. it's literally been like being a doctor, 2 pharmacists, and a bms medical "helper." (my degree is in art and art history, sheesh!) somerset, however, was very kind to me, and one researcher gave me her personal ext.# there...said call back anytime. i DO believe in being highly involved in one's psych care, but i don't feel i should have had to go to such lengths as doing others jobs for them, and continually calling back, to make sure they had followed through. more often than not, they had NOT!
pulse
Posted by pulse on April 14, 2006, at 12:20:31
In reply to Re: Emsam Price/ Pulse, posted by Last Chance on April 14, 2006, at 10:45:44
Richard,
yes, i'd heard that the medical/ healthcare situation in oregon had gone WAY downhill.
sorry, i see i was confused re: your post to which i responded earlier. i didn't "get" that it was your regular pharmacy that quoted the price as $444. wow - costco may be only $300!
now, i'll REALLY get relentless with costco here. i think my best option is to actually go there in person, rather than to just call again. let's see how they deal with ms. petite yet mighty. good luck to me, regardless - they seem to be a bunch of real wankers.
thanks again.
pulse
Posted by pulse on April 14, 2006, at 12:33:13
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
egad, Richard, i so hope that doesn't come to pass. i've heard through the grapevine that the other big drug cos. have put out the "reports" re: nausea, constipation, and other gi problems. hey, as we ALL should know by now, they don't want to lose a dime of their billons that they are already taking many of us for. they do the least possible and only care about those who can somehow tolerate /get a good enough RESPONSE, but rarely FULL remission, with their toxic meds.
i am doing well and intend to stay in deep denial re: ANY gi problems cropping up.
pulse
Posted by verne on April 14, 2006, at 14:23:19
In reply to Tricare coverage!, posted by JaclinHyde on April 13, 2006, at 12:54:34
That's great. I have Tricare and thought they might be slow to insure this. I've had battles with them in the past.
Thanks for the info. I'll mention emsam to my doc next week.
verne
Posted by pulse on April 14, 2006, at 15:58:33
In reply to Re: Tricare coverage! » JaclinHyde, posted by verne on April 14, 2006, at 14:23:19
my slim sw (fairfield) ohio lead (instead of costco) turned out to be a big lead. i have already transferred my Emsam script to jungle jim's, a one-of-a-kind (sorry!) 'multiplex' gourmet food, rare produce, and now, of all things, a pharmacy.
they could not have been more accommodating and helpful. they also happen to be a compounding pharmacy, just fyi.
PRICE: $427 per 30 days - 6 mg. patch. they are planning only to carry the 6 mg., but i believe, since they do so many special orders, they would get in the 9 and 12, upon request. also, they will ship through the us mail.
pulse
Posted by strugglingsteve on April 14, 2006, at 15:59:44
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
> There is a poster, NY Marine, on The Anxiety Community - he is on day 6 of Emsam, and says that he feels "agitated, anxious, nausea". Maybe it is not the miracle that some of us are hoping for. Richard
I have terrible anxiety and agitation and am on day 4 and emsam is having no effect on that. It may be like wellbutrin is for me in that its worse but then gets better. Too soon to tell for anyone right now. Give it 6 weeks and then lets see where we are.
Posted by strugglingsteve on April 14, 2006, at 16:14:15
In reply to Re: Emsam The Anxiety Community, posted by strugglingsteve on April 14, 2006, at 15:59:44
I am going to get a medic alert bracelet if emsam pans out as a long term med. I know with nardil its 10 days off it before hospital surgery or anesthesia at a dentist. Isnt selegiline a very short half life so wouldnt the time off of it be much shorter to, anyone out there with any ideas on this??
Posted by ttee on April 14, 2006, at 17:10:13
In reply to Half life $ Anesthesia, posted by strugglingsteve on April 14, 2006, at 16:14:15
Having a medic alert bracelet sounds like a cheap good thing to do. You never know what could happen in an emergency situation and/or will the resident intern at your local hospital know what EMSAM is?
I think you are right about Selegiline having a sort half-life. However, I don't think the half-life is relevant with an MAOI. Selegiline is an irreversible MAOI, so once you have destroyed your MAO with Emsam, it will take 2 wks after you discontinue the Emsam for you body to remanufacture some normal functioning MAOI. So if Emsam is working for someone, it might be a scary proposition to have to go off of it just to have some minor surgery, or a tooth filling. Will it work again when you restart it, or is it like the other AD's that sometimes doesn’t work again like they had done before stopping them?
TTEE> I am going to get a medic alert bracelet if emsam pans out as a long term med. I know with nardil its 10 days off it before hospital surgery or anesthesia at a dentist. Isnt selegiline a very short half life so wouldnt the time off of it be much shorter to, anyone out there with any ideas on this??
Posted by tom_p on April 14, 2006, at 19:20:15
In reply to Re: Emsam Price, posted by Iansf on April 13, 2006, at 16:39:26
Hi,
I've been reading messages here for years and I thought I'd start posting.
I'm really interested in trying Emsam and I too have been checking prices for the med.
I spoke with someone at Costco and she estimated the cost for 30 days of the 6mg patch at $405.
Another local pharmacy said their price would be $480 to $500.
Tom
Posted by Phillipa on April 14, 2006, at 19:39:36
In reply to Re: Emsam The Anxiety Community, posted by strugglingsteve on April 14, 2006, at 15:59:44
It has to work there has to be something out there. Is it us? Love Phillipa
Posted by strugglingsteve on April 14, 2006, at 21:07:49
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
I couldnt find that posting of ny marine, did anyone else post there?
Posted by Last Chance on April 14, 2006, at 22:25:54
In reply to Re: Emsam The Anxiety Community, posted by strugglingsteve on April 14, 2006, at 21:07:49
> I couldnt find that posting of ny marine, did anyone else post there?
Struggling Steve - sorry, my post wasn't very clear. Go to www.anxietyhelp.org - site is called "The Anxiety Community" Click on Treatment, then list of medications, then Nardil. That will get you to NY Marine's post. Richard
Posted by gardenergirl on April 14, 2006, at 22:56:22
In reply to SW OHIO Decent Price, posted by pulse on April 14, 2006, at 15:58:33
Posted by Sarah T. on April 15, 2006, at 3:59:41
In reply to Re: EMSAM-Day 5-Too early?? » strugglingsteve, posted by RobertDavid on April 12, 2006, at 15:41:49
Hi Robert David,
Your news is wonderful, and I really appreciate your keeping us informed on your progress. Thank you for your reply the other day regarding getting the patch wet. I'm delayed in replying because my computer is ailing.
I'm wishing you continued success with the new medicine.
Sarah
Posted by pulse on April 15, 2006, at 9:44:35
In reply to Love Jungle Jim's! (nm) » pulse, posted by gardenergirl on April 14, 2006, at 22:56:22
gardengirl,
you mean you're in my area and have been to jungle jim's...OR... was this a general (!) comment?
btw, they can save me at least $10-$15 on my 3 other (2 are non-psych meds) scripts.
best,
pulse
Posted by pulse on April 15, 2006, at 9:54:33
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
my report: day 1 & 2 were unbelievably good. day 3, i had a slight dip back into some depression, but my best guess is that the lack of sleep had caught up with me, and caused this. night #3/ day#4 (today) - i got 7 hours sleep in one stretch last night. depression gone again. hoping for repeats from here on...
still NO stomach problems, nor other side-effects. yippee!
pulse
Posted by ravenstorm on April 15, 2006, at 11:51:10
In reply to All - my day #4, posted by pulse on April 15, 2006, at 9:54:33
Congratulations on your lack of side effects! Sorry I didn't respond to your earlier reply about GI problems. The last two days have not been good and I haven't been up to posting.
I became medication intolerant/treatment resistant after a very protracted withdrawal to paxil that left me with worse depression and anxiety than I ever had before. Celexa gave me askathesia (I know I didn't spell that right), Lexapro and zoloft made me throw up. I was about to try prozac (which was the only drug I have ever tried that I didn't have severe start up or discontinuation syndrome with) when my anti-med husband took me to a naturopath who claimed he could cure me with amino acids etc but that I had to take them on an empty stomach etc despite the fact that at the time my stomach was bad enough that taking supplements with food was enough of a problem. Anyway, that not only didn't work, it screwed my stomach up so much that I then couldn't tolerate prozac which was my ace in the hole, so to speak.
Then it was on to remeron. Which, because of its nausea blocking properties, helped me eat for awhile, but made me extremely angry, made my anxiety worse and only gave partial remission to depression. It also permanently altered my blood sugar responses. After several months on this drug, it started causing severe heartburn/gastric distress, however I couldn't just stop taking it due to withdrawal syndrome, so I had to keep taking it for two months as I weaned off and during that time erosions in my esophagus occurred which are taking forever to get under control. I basically can eat oatmeal, rice, potatoes and some chicken and thats about it. Remeron is the first medication I've taken that has done permanent damage to my stomach. The other medications would upset my stomach or make me nauseaus to the point of non functioning, but once I discontinued them I could resume eating somewhat normally.
So, come this September I'll have been in this agitated/depressive episode for three years.
I started following the patch with great interest several years ago because of my stomach issues, but then gave up on it when I delved more into selegine and discovered how activating it was (Wellbutrin and Remeron both made my anxiety/anger worse). So, I am interested to see how someone with severe physical/anxiety/agitation will do on the patch.
Also, at this point, I'm just worried about making myself even worse. When I go through withdrawal to these drugs I end up worse than when I started and I just can't face getting any worse. Its always a huge gamble for me to try another drug.
Sorry this is so long. Thanks for your continued posts and I wish you continued good luck!
Posted by RobertDavid on April 15, 2006, at 13:01:56
In reply to Re: GI issue reply/pulse, posted by ravenstorm on April 15, 2006, at 11:51:10
I'm still void of any negative side effects. It amazes me as I've dealt with SAD and GAD all my life. I'd heard before trying EMSAM that oral selegiline would not be good for someone like me which was of concern, but so far my best start to any med.
One of the many reasons I have not been able to stay on the typical SSRI's and SNRI's was that I just felt more anxious and didn't sleep well (not to mention they didn't work).
Whenever I start a new med I tend to really pay attention to what I'm feeling, like a fear of when the side effects going to kick in and how bad will they be once here. Now at day 9 I put the patch on and don't give it a thought.
If my mood and energy were not better and if my anxiety was not more under control I'd think I was just putting on a piece of tape with no medicine.
My take is that for me I got a quick response, now things are improving gradually. My guess is that I won't know just how much EMSAM is going to benefit me until I get 3 to 4 weeks further out. At that time I can also determine if I will just stay on the 20mg patch or go up.
So at least in my case, a guy that primarily has anxiety issues with some depression, it's helping in all area's with NO side effects. I remain optimistic. Rob
Posted by Crazy Horse on April 15, 2006, at 13:22:18
In reply to Day 9 Report, posted by RobertDavid on April 15, 2006, at 13:01:56
> I'm still void of any negative side effects. It amazes me as I've dealt with SAD and GAD all my life. I'd heard before trying EMSAM that oral selegiline would not be good for someone like me which was of concern, but so far my best start to any med.
>
> One of the many reasons I have not been able to stay on the typical SSRI's and SNRI's was that I just felt more anxious and didn't sleep well (not to mention they didn't work).
>
> Whenever I start a new med I tend to really pay attention to what I'm feeling, like a fear of when the side effects going to kick in and how bad will they be once here. Now at day 9 I put the patch on and don't give it a thought.
>
> If my mood and energy were not better and if my anxiety was not more under control I'd think I was just putting on a piece of tape with no medicine.
>
> My take is that for me I got a quick response, now things are improving gradually. My guess is that I won't know just how much EMSAM is going to benefit me until I get 3 to 4 weeks further out. At that time I can also determine if I will just stay on the 20mg patch or go up.
>
> So at least in my case, a guy that primarily has anxiety issues with some depression, it's helping in all area's with NO side effects. I remain optimistic. RobMan, it's really working for you!! I'm very happy for you Rob. And your reports are giving the rest of us hope in what sounds to be one fine medication. Keep up the good work.
-Crazy Horse
Posted by theo on April 15, 2006, at 14:05:26
In reply to EMSAM-Day 5, posted by RobertDavid on April 12, 2006, at 9:53:45
How did you already get Emsam? I was at the doc yesterday and am going to try it, but my doc said it would be a few more weeks before it hits the shelves??
Posted by RobertDavid on April 15, 2006, at 14:29:53
In reply to Re: EMSAM-Day 5 » RobertDavid, posted by theo on April 15, 2006, at 14:05:26
> How did you already get Emsam? I was at the doc yesterday and am going to try it, but my doc said it would be a few more weeks before it hits the shelves??
I called a few pharmacies till I found one that could order it, then had my doctor call in the perscription by phone. Most pharmacies probably are not stocking it, but can order it. If your pharmacy says they don't have it in there system ask them to check with their wholesaler. By now I'm sure it's easy to get, but your doctor may not be aware that it is. Good luck! Rob
Posted by Last Chance on April 15, 2006, at 14:34:09
In reply to Day 9 Report, posted by RobertDavid on April 15, 2006, at 13:01:56
Hi Rob - As you know I have been waiting a long time for the patch, and now that it is here I can't afford it. I am glad to hear you are doing so well, and wish I were along for the ride. Still trying to figure out a way, but not looking good. Continue to do well, and I know you will keep letting us know how it's going. Richard
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