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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by bulldog2 on December 16, 2006, at 13:12:39
Does anyone know if decongestant nasal sprays can be used with the emsam 6 mg patch? I know you can't used the pseudofed pills with emsam but with a spray I don't know how much actually gets into your system.
Posted by laima on December 16, 2006, at 15:13:04
In reply to Emsam and Nasal Sprays, posted by bulldog2 on December 16, 2006, at 13:12:39
I think it's ok, at least with some. I was given prescription "fluticasone propionate nasal spray", and I made sure doctors and pharmacist knew I was using Emsam, too. I didn't have any problems with it.> Does anyone know if decongestant nasal sprays can be used with the emsam 6 mg patch? I know you can't used the pseudofed pills with emsam but with a spray I don't know how much actually gets into your system.
Posted by RN320 on December 16, 2006, at 17:25:17
In reply to Emsam and Nasal Sprays, posted by bulldog2 on December 16, 2006, at 13:12:39
Hi Bulldog-
I've been on EMSAM for >6months now. I had a bad cold early on at the 6mg dose (I'm at 12mg now). I was told that the intranasal corticosteroids like Flonase (fluticasone) are ok. I was told that Afrin spray, which I love, was not to be used on EMSAM. I now use Flonase daily, and supplement with Benadryl (which is safe to use with EMSAM) to supplement for congestion and it seems to have worked pretty well. Hope that helps.
/m
Posted by NYCguy on December 17, 2006, at 8:20:33
In reply to Re: Emsam and Nasal Sprays, posted by RN320 on December 16, 2006, at 17:25:17
> Hi Bulldog-
> I've been on EMSAM for >6months now. I had a bad cold early on at the 6mg dose (I'm at 12mg now). I was told that the intranasal corticosteroids like Flonase (fluticasone) are ok. I was told that Afrin spray, which I love, was not to be used on EMSAM. I now use Flonase daily, and supplement with Benadryl (which is safe to use with EMSAM) to supplement for congestion and it seems to have worked pretty well. Hope that helps.
> /mHi RN320,
I'm curious... You mentioned that you've been on EMSAM for a while now. Might I ask what you're taking it for and how well it has or has not helped with your symptoms? What changes did you notice when you made the switch up to the 12mg patch?
Thanks for your time! =)
Posted by saturn on December 19, 2006, at 20:32:46
In reply to Emsam and Nasal Sprays, posted by bulldog2 on December 16, 2006, at 13:12:39
>>> Does anyone know if decongestant nasal sprays can be used with the emsam 6 mg patch? I know you can't used the pseudofed pills with emsam but with a spray I don't know how much actually gets into your system.
Do you mean like the Vicks nasal spray (which contains methamphetamine) or a steroid like flonase/fluticasone?
Posted by saturn on December 19, 2006, at 20:45:10
In reply to Re: Emsam and Nasal Sprays » bulldog2, posted by saturn on December 19, 2006, at 20:32:46
BTW I just checked the website and I'm unsure if Vicks makes the nasal spray/inhaler with (L)-Methamphetamine anymore...at least in the US. I recall buying one about two years ago, but I suspect they just use phenylephrine or oxymetazoline now. Phenylephrine is an alpha-1 antagonist, so you may want to check on that. Supposedly nasal sprays achieve negligable systemic concentrations.
Posted by christophrejmc on December 19, 2006, at 22:24:07
In reply to Re: Emsam and Nasal Sprays, posted by saturn on December 19, 2006, at 20:45:10
Posted by christophrejmc on December 19, 2006, at 22:29:10
In reply to Emsam and Nasal Sprays, posted by bulldog2 on December 16, 2006, at 13:12:39
From personal experience, reports from others here and I think at least one study: OTC sprays with oxymetazoline (and probably xylometazoline) are safe for use with MAOIs. They would probably be even safer with EMSAM at low doses.
Prescription steroid sprays are safe.
Decongestant sprays with phenylephrine, oral decongestants with phenylephrine (eg, Sudafed PE) and decongestants with pseudoephedrine (eg, original Sudafed) are not safe and should be avoided.
Posted by Caedmon on December 20, 2006, at 4:07:16
In reply to Re: Emsam and Nasal Sprays » bulldog2, posted by christophrejmc on December 19, 2006, at 22:29:10
You got it!
BTW I take MAOI Parnate. I use intranasal fluticasone [Rx Flonase] on a more-or-less ongoing basis. I also use oxymetazoline in the rare case of a cold-related congestion episode.
- Chris
> From personal experience, reports from others here and I think at least one study: OTC sprays with oxymetazoline (and probably xylometazoline) are safe for use with MAOIs. They would probably be even safer with EMSAM at low doses.
>
> Prescription steroid sprays are safe.
>
> Decongestant sprays with phenylephrine, oral decongestants with phenylephrine (eg, Sudafed PE) and decongestants with pseudoephedrine (eg, original Sudafed) are not safe and should be avoided.
>
Posted by bulldog2 on December 20, 2006, at 8:15:52
In reply to Re: Emsam and Nasal Sprays » christophrejmc, posted by Caedmon on December 20, 2006, at 4:07:16
From personal experience, reports from others here and I think at least one study: OTC sprays with oxymetazoline (and probably xylometazoline) are safe for use with MAOIs. They would probably be even safer with EMSAM at low doses.
>
Yes I would be combining emsam and oxymetazoline(afrin). Did you get the go ahead from you doctor before trying the combo? Do you recall the study?
Posted by RN320 on December 22, 2006, at 2:44:54
In reply to Re: Emsam and Nasal Sprays, posted by NYCguy on December 17, 2006, at 8:20:33
Hi Bulldog-
I started out on 6mg during the first week of June, went to 9mg in mid July and up to 12mg in early September. I am being treated for TRD since 04/01 which came on suddenly and is attributed to the aftermath of an hysterectomy. I'm 49 and I dropped like a rock 3 weeks post-op and was close to catatonia during the 1st hospitalization. I had failed ECT and had been on just about every other combination of antidepressants which were not (or only slightly) effective for me. I am on a big combination of psych and cardiovascular medications right now- the psych ones are EMSAM 12mg, trazadone 600mg, Geodon 180mg, and seroquel 100mg. The only real problem I have that's attributed to the EMSAM is pretty severe orthostatic hypotension, but the trazadone has really added to this problem too.At 6mg, I was able to focus more on day to day activities and generally felt more "well wrapped"! It did nothing for my anxiety at that dose. I didn't think that my mood was really affectd at the 6mg, but there was a change noticed by my therapist, pdoc and family.
At 9mg I was even more focused- could watch TV for close to an hour and retain it. Still not able to read well enough to read a book- magazine and newspaper articles were about it for me. There was no real change in my mood that I could sense, although my friends, family and PDOC noticed a difference- They said that I was "much brighter"than at the lower dose.
At 12mg, there is a definite improvement in my mood, decreased anxiety and I CAN NOW READ BOOKS!!!!! I can read for up to an hour and not get confused. Another thing that happened was that in the first 7 days of the 12mg dose, I lost 11 lbs. My pdoc said that this is not necessarily always the case, but it can happen. I've had no further weight loss attributed to the higher dose since the first week. At this dose, I am also actually able to accomplish much more in my life (still not the way I was pre-depression, but I'm told that it's unlikely that I'll ever really get back to the high level of function that I was so used to) relative to keeping up my house, even cooking a little, running errands, keeping track of my meds, writing checks and getting it right! This is the first year in 5 years that I'm actively involved in planning and participating in the holidays, which used to be my favorite time of the year. It's the first time that I've been somewhat happy about the holiday season- the past 5 Christmases it's been unbearable, so this is just the most amazing gift I could get, and I have attributed it to "life on EMSAM". I'm really happy that all of the docs that worked so hard to help me, and my family and friends are going to see me happy this year,as it's been such a long struggle.
Don't get me wrong, I still have bad days every once in awhile, but they're much less in frequency than before the EMSAM. And I personally don't think that the bad days are as bad as they were before. I have found with the EMSAM at the 12mg dose that I'm able to be much more positive in my thoughts about things than before, and that's been really helpful. My pdoc and therapist continue to use the word "fragile" when they talk about me, which ai'm not so crazy about, but it sometimes helps to put things in perspective (like not being able to handle much stress or change).
I hope that I answered you questions....if not, let me know and I'll give it another try. I hope you have a nice holiday, Bulldog!
/m
Posted by christophrejmc on December 22, 2006, at 16:34:08
In reply to Re: Emsam and Nasal Sprays, posted by bulldog2 on December 20, 2006, at 8:15:52
> Yes I would be combining emsam and oxymetazoline(afrin). Did you get the go ahead from you doctor before trying the combo? Do you recall the study?
My doctor told me that she doesn't think it would be a problem, but to use caution. She has, however, had experience with a quite serious MAOI+pseudoephedrine interaction before.
I did a quick search on pubmed and I haven't been able to find the study yet, you may try looking in the PB archives. Oxymetazoline (I believe) is an alpha1 adrenergic agonist, so there is a potential for an interaction.. I wouldn't have used it with an MAOI if I weren't hopelessly addicted to OTC decongestants.
This is the end of the thread.
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