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Dr. Bob is Robert Hsiung, MD,
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Posted by gibber on July 26, 2007, at 23:12:52
In reply to Re: EMSAM - First Day » headcheese01, posted by Robert David on July 22, 2007, at 14:01:51
I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. I took some holidays from Lamictal (a week or two). But I seem to keep coming back. I seem to feel better on it. It has been a long time since I've been to this board. Probably since I started EMSAM. I know it is so hard living for some of you. I have been there before. I would say I'm happy infrequently, but light years from where I used to be. I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. I'm still in CBT. I'm able to hold a rather demanding job and I'm going back to my second semester of music school. Just throwing this out there, because I know many of you need some hope. Let me know if you have any question about anything.
> > Robert David,
> >
> > If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?
>
>
>
> I tried EMSAM to improve my mood, give me more energy and improve mental clarity. Also, I had hoped it might be a replacement for klonopin to treat SAD, GAD and mild depression (not clinical depression/anxiety related) which disabled me socially for over half my life prior to klonopin.
>
> All other meds I tried as mono therapy or combined with klonopin were a bust for me. All side effects and no benefit.
>
> When I started EMSAM in April 06 I was taking 2mgs klonopin down from 3. I had a very positive initial response to EMSAM. I had a suttle energy boost and sense of improved mental clairty. I was very encouraged.
>
> I started having some slight issues with insomnia, but not enough to get me to stop EMSAM as I have never been a good sleeper. After a while and with my doctors permission I started to do a few things to see if I could improve sleeping.
>
> First I cut the patch in half, basically to try it at a lower dose. I also tied taking it off a few hours before bedtime then back on early in the morning. Both helped.
>
> During the 4 +/- months I was on EMSAM I had the energy to get back to the gym and was exercising more and was overall more motivated at work and feeling better. I improved many areas of my life such as eating better.
>
> One night I took off the patch before bedtime and over the weekend didn't put it back on without noticing much differenceon how I felt. Then it got to be a week. At that point I stopped taking it and have not been back on it since.
>
> While on EMSAM I was able to drop down to 1.5mgs klonopin where I still am today. Klonopin works as well for me now as it did at 3mgs, but with less tiring side effects.
>
> So my overall take on EMSAM is for me it was the best anti depressent I've tried. It really helped give me a boost to get me going again. I don't seem to need anything other than klonopin at this time. I kept my half box of EMSAM and would not hesitate to go back on it again if I slipped back to the way I used to feel.
>
> Though I have not followed the board much since stopping EMSAM I hope there are others that have found it to be helpful.
>
>
>
>
>
Posted by headcheese01 on July 27, 2007, at 8:00:10
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
>>>I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. ... I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. ...<<< - Gibber
Hi Gibber,
So, if I read this right, you quit Emsam around 6 months ago, but it had worked for you before, like it did for Robert David?
Just curious, how come you quit it? And when you did take it, were there any side effects that you experienced. I'm new on Emsam myself (8 days). Still figuring out timing of taking the drug, and if the moderate fatigue issues that I get with it will resolve over a couple of weeks, or if that's just the way it will be with Emsam.
I'm a super fast metabolizer, so with all the AD's I ever took, I felt the drug kick in within an hour or so of taking it, and then depending on the drug, I felt something good for a couple to a few (but not more than 4) hours, then I'd crash. Over the years, I had concluded that that experience wasn't worth taking the meds. Yet, I remained by and large depressed... to the point that I actually had VNS implanted. VNS has been a little bit helpful, but not near enough.
So... I finally decided to give an AD another try, and it's Emsam. So far, I'm experiencing similar stuff to what I've experienced with other meds; that is, a couple of hours of feeling good, followed by a couple of hours of moderate fatigue, followed by a few hours of lesser fatigue; then I get really tired and go to bed.
It's all new to me though, so I'll try to give this a good 6 weeks unless side effects become too burdensome.
Posted by jenro on July 27, 2007, at 11:02:11
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
>
what's cbt?
I had a similar experience as Mr. David. Exept I was on Emsam for more like a year/year and a half. Later on I combined it with Lamictal. I am still am on Lamictal. I took some holidays from Lamictal (a week or two). But I seem to keep coming back. I seem to feel better on it. It has been a long time since I've been to this board. Probably since I started EMSAM. I know it is so hard living for some of you. I have been there before. I would say I'm happy infrequently, but light years from where I used to be. I started CBT around the time I started emsam (2 years ago). I am a strong believer CBT. This is after taking every drug available and doing years of psychodynamic therapy too. I'm still in CBT. I'm able to hold a rather demanding job and I'm going back to my second semester of music school. Just throwing this out there, because I know many of you need some hope. Let me know if you have any question about anything.
>
> > > Robert David,
> > >
> > > If you don't mind sharing, could you share why you stopped taking Emsam? It seemed to be working so brilliantly for you. How many months did you take it before you quit it?
> >
> >
> >
> > I tried EMSAM to improve my mood, give me more energy and improve mental clarity. Also, I had hoped it might be a replacement for klonopin to treat SAD, GAD and mild depression (not clinical depression/anxiety related) which disabled me socially for over half my life prior to klonopin.
> >
> > All other meds I tried as mono therapy or combined with klonopin were a bust for me. All side effects and no benefit.
> >
> > When I started EMSAM in April 06 I was taking 2mgs klonopin down from 3. I had a very positive initial response to EMSAM. I had a suttle energy boost and sense of improved mental clairty. I was very encouraged.
> >
> > I started having some slight issues with insomnia, but not enough to get me to stop EMSAM as I have never been a good sleeper. After a while and with my doctors permission I started to do a few things to see if I could improve sleeping.
> >
> > First I cut the patch in half, basically to try it at a lower dose. I also tied taking it off a few hours before bedtime then back on early in the morning. Both helped.
> >
> > During the 4 +/- months I was on EMSAM I had the energy to get back to the gym and was exercising more and was overall more motivated at work and feeling better. I improved many areas of my life such as eating better.
> >
> > One night I took off the patch before bedtime and over the weekend didn't put it back on without noticing much differenceon how I felt. Then it got to be a week. At that point I stopped taking it and have not been back on it since.
> >
> > While on EMSAM I was able to drop down to 1.5mgs klonopin where I still am today. Klonopin works as well for me now as it did at 3mgs, but with less tiring side effects.
> >
> > So my overall take on EMSAM is for me it was the best anti depressent I've tried. It really helped give me a boost to get me going again. I don't seem to need anything other than klonopin at this time. I kept my half box of EMSAM and would not hesitate to go back on it again if I slipped back to the way I used to feel.
> >
> > Though I have not followed the board much since stopping EMSAM I hope there are others that have found it to be helpful.
> >
> >
> >
> >
> >
>
>
Posted by Phillipa on July 27, 2007, at 19:16:40
In reply to Re: EMSAM - First Day, posted by jenro on July 27, 2007, at 11:02:11
Wasn't EMSAM released last April? Just asking. Love Phillipa ps could have been May.
Posted by d0pamine on July 31, 2007, at 10:59:25
In reply to Re: EMSAM - First Day, posted by gibber on July 26, 2007, at 23:12:52
For the record, I was also on EMSAM 12mg for 1.5 years and it was a miracle patch for me. (especially once I figured out that potassium citrate cured the associated insomnia) I quit because of the evening time fatigue that it had started causing me.
Posted by RobertDavid on October 2, 2007, at 0:08:02
In reply to EMSAM - First Day, posted by RobertDavid on April 8, 2006, at 11:15:36
Went back on EMSAM again today. I've come to realize that the financial stress of business (mortgage business) along with relationship issues have beaten me down. Others have pointed out to me that I'm not myself, drained of energy. I'm depressed and can feel it.
So this morning I cut a 6mg patch into quarters, put one of the quarters on and off to work I went.
I ended up having a much more productive day. My response to EMSAM is as I recall it the first time it tried it over a year ago. I felt sharper and had more energy, no negative side affects (yet).
I'll post more after giving it more time. I'm hopeful I will continue to have a positive response on this low dose and EMSAM will be the crutch I need to get me through this difficult period........
Posted by KayeBaby on October 2, 2007, at 16:31:23
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Sorry that you need it but welcome back!
I have been on Emsam since early this spring and went up to 9 mg a little over a month ago. It is a good med for me with few if any discernable side effects.
Kaye
Posted by Phillipa on October 2, 2007, at 20:25:42
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Rob sent you a babblemail. My favorite person of all time so good to see you back but not under the circumstances. People this is a wonderful person truly believe me All my love Phillipa
Posted by Brody on October 2, 2007, at 22:36:35
In reply to First Day - Again, posted by RobertDavid on October 2, 2007, at 0:08:02
Posted by Breizenby on October 16, 2007, at 14:15:55
In reply to Re: d0pamine - your Emsam story please, posted by lcat10 on March 27, 2007, at 22:50:14
Has anyone haad an allergic reaction to the patch? If so, what did you try next. I LOVED THE PATCH. It worked wonders within two days.
Posted by ramsea on October 17, 2007, at 2:01:32
In reply to Re: Allergic reaction to patch, posted by Breizenby on October 16, 2007, at 14:15:55
hi, over the years i have found that Seleginine helps me very much with depression. Is it the same substance and if it is, is it the same dosage ratio?
I mean, I take about 40 mg of Seleginine and I read that 9 mg is pretty high for Ensame. Does anybody know?ramsea
Posted by KayeBaby on October 17, 2007, at 17:09:35
In reply to Re: relation to seleginine????, posted by ramsea on October 17, 2007, at 2:01:32
It is the same substance but the doasge ratio is a bit hard to figure.
I'm on the 9mg and it says on the package 9mg/24hrs and then also above that it says 30mg. So is the 9mg patch equal to 30mg orally?
Somebody here knows and will answer you.
Kaye
Posted by ramsea on October 18, 2007, at 0:45:24
In reply to Re: relation to seleginine????, posted by KayeBaby on October 17, 2007, at 17:09:35
Posted by psychobot5000 on October 21, 2007, at 21:15:08
In reply to Re: relation to seleginine????, posted by KayeBaby on October 17, 2007, at 17:09:35
I have posted on this subject before, though my figures included guesswork.
Nevertheless, the way it was described to me by someone who was integrally involved with the development of the EMSAM patch is as follows:
EMSAM and selegiline are the same substance. However, you would need a very high dosage of oral selegiline (perhaps 80mg taken orally) to get the same blood-levels of selegiline as you get from a 6mg EMSAM patch worn for 24 hours. The reason is that the patch has a much higher efficiency at getting the drug into your bloodstream. This leads to another difference: much of the selegiline you take orally passes through the liver on its way into the bloodstream. The liver processes much of the dose into other active chemicals: amphetamines, mostly. So with an oral dose, you get the impurity of those amphetamine metabolites also.
In sum, as I understand it, the patch gives higher blood levels of the parent drug, with much lower blood levels of amphetamine metabolites, so there is a modest practical difference between them, though they're the same drug.
Posted by ramsea on October 22, 2007, at 1:25:41
In reply to Re: relation to seleginine????, posted by psychobot5000 on October 21, 2007, at 21:15:08
Posted by War-Face on October 22, 2007, at 13:44:41
In reply to Re: relation to seleginine????, posted by psychobot5000 on October 21, 2007, at 21:15:08
> EMSAM and selegiline are the same substance. However, you would need a very high dosage of oral selegiline (perhaps 80mg taken orally) to get the same blood-levels of selegiline as you get from a 6mg EMSAM patch worn for 24 hours. The reason is that the patch has a much higher efficiency at getting the drug into your bloodstream. This leads to another difference: much of the selegiline you take orally passes through the liver on its way into the bloodstream. The liver processes much of the dose into other active chemicals: amphetamines, mostly. So with an oral dose, you get the impurity of those amphetamine metabolites also.
>
> In sum, as I understand it, the patch gives higher blood levels of the parent drug, with much lower blood levels of amphetamine metabolites, so there is a modest practical difference between them, though they're the same drug.
This is a great response to the question regarding dosing and actual blood level differences between oral and transdermal selegiline. Given the differences in blood levels between the two, I wonder if the dose of selegiline provided by Emsam might be BEYOND the dose recommended to prolong life. It seems that in lab tests, there is a bell curve in dose for maximum longevity of mice: give too little, no increase in life span is seen, give too much, and lifespan actually decreases. Would the blood level of selegiline achieved through a dose equivalent to Emsam 6 mg put lab rats out of the beneficial range on this bell-curve in lab rats? Would this correspond to human longevity?Here is an interview with Dr. Joseph Knoll, who discovered selegiline and also reported on its tendency to increase the life of lab rats to various extents depending on the dose/weight ratio:
http://www.smart-publications.com/articles/MOM-knoll.php
Based on his findings with lab rats, I believe Knoll says that the ideal dose to increase human life is something like 1 to 2 mgs per day, which increases with age.
Then, a study done with dogs found that a MUCH higher dose, equivalent to "77 mg/day for a 170-pound person" increased the life span of dogs. Here is a full quote, with link below (which provides reference to the actual study):
"Although it takes too many years to do lifespan studies on long-lived species, another experiment was conducted on elderly beagle dogs. The dogs were given the equivalent of 77 mg/day for a 170-pound person. 80% of the deprenyl dogs survived to the end of the experiment, whereas only 39% of the placebo dogs survived [*6]."
http://www.benbest.com/lifeext/deprenyl.html
I am very curious as to how the delivery of selegiline might alter Knoll's findings on longevity, which of course was conducted on mice. Any thoughts on this subject?
Posted by Phillipa on October 22, 2007, at 20:42:36
In reply to selegiline dose/delivery and longevity??, posted by War-Face on October 22, 2007, at 13:44:41
Would EMSAM do the same? Phillipa
Posted by War-Face on October 22, 2007, at 21:07:34
In reply to Re: selegiline dose/delivery and longevity?? » War-Face, posted by Phillipa on October 22, 2007, at 20:42:36
Posted by Phillipa on October 22, 2007, at 21:30:56
In reply to That's what I'm asking :) (nm) » Phillipa, posted by War-Face on October 22, 2007, at 21:07:34
Well then I hope you're right. Phillipa ps wanted to try EMSAM for the longest time. Two boxes waiting to be used.
Posted by KarenRB53 on May 7, 2008, at 14:58:56
In reply to Re: EMSAM » jetcity10, posted by RobertDavid on April 27, 2006, at 0:14:56
> > I have now been on EMSAM for one week. Though I have not seen a miraculous improvement I have to say that there is clearly some improvement. I too have been on and off numerous anti-depressants through the years with little positive effect and lots of negative effects. This is the first where I can see some raising of the lowest feelings. I have also had glimpses of hope which I have not had in years and glimpses of a positive life - both of which are new since EMSAM. I still feel depressed, but like I said, the low seems a little better. The anxiety is pretty high. However both the depression and anxiety are probably influenced by significant life events that had increased the severity of both before starting the EMSAM.
> >
> > As to side effects: maybe some increased anxiety, maybe less sleep (even on the 1.5mg Klonipin), a little orthostatic hypotension, and it looks like some minor constipation.
> >
> > But I have more energy (even with less sleep) and have even been looking forward to working out (an amazing thought).
> >
> > Overall, this has been one of the best responses I have ever had since there is positive response and no side effects I can't deal with yet.
> >
> > Rob, thanks for your posts, it gives hope that it can get even better, but even if it doesn't, some is better than none.
>
>
> That sounds like a very positive start and similar in many ways to mine. I too noticed that I slept a little less at first, but woke up energized, felt like doing more. I too started working out at the gym again as before I just didn't couldn't get myself to do go there.
>
> I hope that your benefits will continue and side effects will be minimal. Like you I never really knew what it felt like to have a postive start any med other than klonopin.
>
> Please keep posting your results and I wish you the best! Rob
Are you still using EMSAM and is it still working as well for you?Thanks, Karen
Posted by KarenRB53 on May 7, 2008, at 15:07:42
In reply to Re: EMSAM-Time for next refil, posted by Paul on Long Island on April 30, 2006, at 19:09:06
> Hi guys...Paul again. First off, I want to congratulate you Rob for the wonderful response you've gotten on the medication. I hope and pray that so many, many people will find the same kind of relief you've found. Unfortunately, I've come to the conclusion, for several reasons, that I'm not going to be one of those lucky ones with Emsam. I've been on the patch for 13 days now. While I know most people shouldn't expect to have a great, or perhaps even minor improvement in that time, I've had a worsening, horrible depression and SEVERE anxiety and OCD in that time. My original reasons for going on emsam were due to a large weight gain and sexual side effects from prozac. Foolishly and selfishly, I didn't appreciate the fact that those things are extremely minor in the grand scheme of things, considering I had always had GREAT help from the prozac. Several people questioned why I would stop taking something so effective for only a possibility of relief from something completely different. While it may have made some kind of weird sense to me at the time, those of you who questioned it were absolutely right. Except for those side effects, I was living a very good, relatively stable emotional life. I have an appointment with my psychiatrist tomorrow, and I plan to tell her I'm quitting the emsam. She had given me lithium to try to boost the effect of the emsam, along with klonopin and xanax to get through the severe anxiety. So, I'm hoping to muddle through the next 14 days until I can go back on prozac. I hope I don't lose what's left of my mind :) One concern I have now is EGAS's posting. Apparently you've had trouble with getting off of the emsam. You mentioned severe anxiety and panic. I pray that those things will go away for you quickly. I hope that between the lithium, klonopin and xanax, I can avoid feeling any worse than I have for the past 2 weeks. It seems like the effects you've gotten from withdrawal from the emsam are the same effects I've gotten while ON it! I guess time will tell. I'll let you all know how I make out. And please, EGAS, keep us posted on how you make out. I'm pulling for you, and I'm sure everyone else is also. One more time, I want to thank you all for the incredible support, information and advice you've all given. Whatever else can be said about people with our conditions, you're obviously all extremely giving and caring people. God Bless you all! Paul
Just wondered if you did go back to Prozac? I've got the same problem with Prozac. I've been on it approx 10yrs and I've gained 30 lbs but also I now have high blood pressure, high cholesterol, hypothyroidism and type2 diabetes. I'm not saying its all the Prozac but partly could be. Also, the last few months Prozac does not seem to be working as well so I've been considering the EMSAM patch.
Thanks for any info.
Karen
Posted by KarenRB53 on May 7, 2008, at 15:12:39
In reply to Re: EMSAM-Time for next refil » theo, posted by RobertDavid on May 2, 2006, at 18:24:55
> > I'm starting the patch as soon as I get my nerve up, I have had the scrip for a week!
> >
> > Do you find any difference in absorbtion in placing it on your upper body versus your thigh or hip (underwear area)?
>
>
> I've pretty much kept the patch on my upper back, chest and arms. I like to keep it high as I like to take long hot baths at night and they say you're suppost to avoid long periods of heat exposure so by keeping it high it doesn't soak in the hot water (for long periods).
>
> On a couple of occations I placed it on my stomach, but never my legs. There are so many options to place it I really don't pay much attention to it and can't say that I've noticed much difference. The chart seems to suggest that it's fine either upper or lower body (outer thighs), but I suspect it doesn't make much difference. I just slap it on where ever I feel like it.
>
> Since I've had such a positive response I will say I like the idea of having on my upper body as I want as much of the drug to get to my brain as possible, but that's just my little mental thing and probably doesn't matter at all. Once I put it on I give it a few good slaps to make sure it sticks well as I want the selegiline to really soak in.
>
> I wish you the best of luck with it and I hope this info helps. RobJust wondered if you're still using the EMSAM and how well its still helping you? I've been considering it.
Karen
Posted by RobertDavid on May 7, 2008, at 16:33:19
In reply to Re: EMSAM-Time for next refil, posted by KarenRB53 on May 7, 2008, at 15:12:39
> Just wondered if you're still using the EMSAM and how well its still helping you? I've been considering it.
>
> Karen
Karen, I'm not currently taking it. It helped me through the issues I was dealing with during that period. I have gone back to it a few times when I needed to and always seem to get a quick positive response. I found I only needed a small dose to help me, sometimes even cutting the patch in thirds.But my primary disorter is anxiety and have continued to take Klonopin for that. EMSAM was something that in small doses helped with energy, mood and mental clarity, but I suspect not with anxiety. When I'm doing good, taking good care of myself, working out, eating right and keep my stress low I've found I can make it without EMSAM. I'm not clinically depressed so my circumstances, dosing and usage probably doesnt apply to most.
I still keep it and will go back to it if and when needed. Provigil at a super low dose (25mgs) has also helped me with the above mentioned issues on occation.
I hope that is of some help to you....
Rob
Posted by Phillipa on May 7, 2008, at 19:29:34
In reply to Re: EMSAM-Time for next refil, posted by RobertDavid on May 7, 2008, at 16:33:19
Hi my friend. Miss you. Love Jan
Posted by daflyingmir on August 18, 2008, at 4:31:13
In reply to Emsam Price, posted by cecilia on April 11, 2006, at 18:10:24
I just wanted to share that I have been on emsam for one year and had very few problems. I'm on the lowest dose and I don't have to worry about being on that special diet. On the otherhand, you should follow the restrictive medications list. I had the starting of a hypertensive crisis after being put on adderall with my emsam. Even though it's clearly marked that they interact, the doctors (the same ones that prescribed me the patch so you'd think they would know better)put me on it anyway. Once I stopped taking the adderall within 2 days my symptoms went away with the hypertensive crisis but I had to be observed just in case it had gotten worse. Other than that I have had no problems with it whatsoever. It's important to remember to change it every single day, there was a few times I forgot to change it for 3 days in a row and my depression came back with a vengance but once I started changing again it took me about 5 days to get back to "normal". It helps with my anxiety alot too. I no longer get panic attacks and can now do the things I used to avoid because of them. I hope this helps everybody :-)
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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