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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Economist on April 6, 2010, at 20:35:24
Is it possible to be on an antidepressant for 5 weeks and feel absolutely nothing, not even a slight improvement, then all of a sudden have a response on the 6th week? Has anyone here had an actual experience like this?
I have been on 6mg EMSAM now for 4 weeks and keep waiting for something to change. Nothing's happening.
Posted by gman22 on April 6, 2010, at 21:04:53
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
Weird but when I start up AD's, I have a few bad days followed by a good few weeks. At the 2-3 week point I begin to have almost bipolar type symptoms of profound inner anxiety and depression, with high points in between. This usually stabilizes in the 4 to 5 week range and then things are fine (except for usual side effects of apathy and fatigue). So it is quite likely that your brain can take 5 weeks to adapt to the neurochemical changes.
Posted by viper1431 on April 6, 2010, at 23:21:22
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
It wouldn't suprise me with ENSAM. I havn't been on it but i've been on the other MAOI's and they all didn't seem to do anything at all for a number of weeks and then one day all of a sudden it was like a switch is hit and thy kicked into action big time.
> Is it possible to be on an antidepressant for 5 weeks and feel absolutely nothing, not even a slight improvement, then all of a sudden have a response on the 6th week? Has anyone here had an actual experience like this?
>
> I have been on 6mg EMSAM now for 4 weeks and keep waiting for something to change. Nothing's happening.
Posted by Phillipa on April 6, 2010, at 23:23:54
In reply to Re: Delayed response with antidepressants?, posted by gman22 on April 6, 2010, at 21:04:53
Seriously Emsam was definitely interested and did quite a bit of research when it first out and followed closely on here. Seems people initially reacted with insomnia. Economist you feel nothing or nothing good? Phillipa ps I do think the transdermal way is the way to go protects liver. If it works it would be so great!!!!
Posted by Economist on April 7, 2010, at 0:05:12
In reply to Re: Delayed response with antidepressants? » Economist, posted by viper1431 on April 6, 2010, at 23:21:22
> i've been on the other MAOI's and they all didn't seem to do anything at all for a number of weeks and then one day all of a sudden it was like a switch is hit and thy kicked into action big time.
God, I really hope so. Thanks for letting me know. If the MAOIs were working for you, why did you stop?
Posted by ace on April 7, 2010, at 3:13:26
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
> Is it possible to be on an antidepressant for 5 weeks and feel absolutely nothing, not even a slight improvement, then all of a sudden have a response on the 6th week?
Yes. I have heard of very specific onsets- people remembering the actual time and place the med kicks in.
Usually i think an SSRI or TCA (if dose high enough) would kick in before the 6 week mark, but not always.
MAOI's take longer
Has anyone here had an actual experience like this?
>
> I have been on 6mg EMSAM now for 4 weeks and keep waiting for something to change. Nothing's happening.If you can hang it out for 2-3 more weeks, I would....
Posted by viper1431 on April 7, 2010, at 9:52:35
In reply to Re: Delayed response with antidepressants? » viper1431, posted by Economist on April 7, 2010, at 0:05:12
> > i've been on the other MAOI's and they all didn't seem to do anything at all for a number of weeks and then one day all of a sudden it was like a switch is hit and thy kicked into action big time.
>
> God, I really hope so. Thanks for letting me know. If the MAOIs were working for you, why did you stop?Unfortunalty i had a really bad case of hypotension as a side effect, which also only kicked in after some weeks when the good effects did.. but i was randomly fainting many times a day and my head couldn't take any more bashing.. Tried many things to raise my BP but after multiple attempts at nardil and parnate i just had to give up.
Posted by ed_uk2010 on April 7, 2010, at 13:59:26
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
> Is it possible to be on an antidepressant for 5 weeks and feel absolutely nothing, not even a slight improvement, then all of a sudden have a response on the 6th week? Has anyone here had an actual experience like this?
>
> I have been on 6mg EMSAM now for 4 weeks and keep waiting for something to change. Nothing's happening.For me, ADs always took many weeks for work. There was no sudden improvement, it was a slow process.
Posted by em_kath on April 7, 2010, at 16:50:39
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
> Is it possible to be on an antidepressant for 5 weeks and feel absolutely nothing, not even a slight improvement, then all of a sudden have a response on the 6th week? Has anyone here had an actual experience like this?
> I have been on 6mg EMSAM now for 4 weeks and keep waiting for something to change. Nothing's happening.
I was on 9mg EMSAM for 7 weeks with no noticeable improvements or side effects. Then one day I began to have hypotensive side effects, and around week 8 I felt a mood lift. It wasn't super sudden as if I woke up one morning and felt like a different person, but I can recall the day that I could tell something was different. I didn't really believe my pdoc when he said it might take that long, I thought he was just being overly efficient by keeping me on it. I was extremely frustrated and I had made up my mind that I was going to switch off of it, and then I felt the change. So I guess I would say that I've experienced what you're asking about.Unfortunately it was not a sufficient improvement and I am switching back to a Wellbutrin/SNRI combo (currently on washout). If I could've had my way I would probably have abandoned EMSAM after 6 weeks, but my pdoc wanted me to wait and see. Even after it became apparent that it was not the drug for me, my pdoc had me go up to the 12mg dose for 3 weeks just to be sure. I guess I'm glad I did, just so that I won't have to wonder if I might have had a miraculous recovery if I had just been patient a little longer, especially since I had already invested so much time in it. Now if I ever decide to try another MAOI I can cross EMSAM off the list knowing I gave it a fair chance.
I went from 6mg to 9mg after only 2 weeks, so you could probably try increasing the dose. I hope you feel an improvement soon!
Posted by Economist on April 7, 2010, at 20:49:17
In reply to Re: Delayed response with antidepressants? » Economist, posted by em_kath on April 7, 2010, at 16:50:39
em_kath,
Did you discontinue EMSAM because it worked initially and then pooped out, or was the mood lift consistent but just not as high as you were hoping for?
Posted by lewyfly on April 8, 2010, at 5:26:54
In reply to Delayed response with antidepressants?, posted by Economist on April 6, 2010, at 20:35:24
I have been on 30mg parnate now for 7 weeks and have noticed some improvement of symptoms.
However I increased to 40mg 5 days ago, and my mood has crashed badly over the last couple of days. Can't understand what has happened but p doc told me hang in there on the 40mg.
It is bloody hard though!!
Posted by em_kath on April 8, 2010, at 14:43:11
In reply to Re: Delayed response with antidepressants? » em_kath, posted by Economist on April 7, 2010, at 20:49:17
> Did you discontinue EMSAM because it worked initially and then pooped out, or was the mood lift consistent but just not as high as you were hoping for?
I ended up discontinuing because while EMSAM was better than nothing, I didn't feel like it was better than my previous medications. When I felt that mood lift I guess it made me hopeful that it would happen again and that I would continue to improve, but I never did. But I don't think that it pooped out at all, I stayed pretty much at that level until I switched off. I wasn't as miserable as before, but I still had a lot of symptoms. My pdoc and I considered adding Lamictal or something but since so few meds can be used with MAOIs we eventually opted to just try something else altogether. I should mention I was also augmenting with 25mcg cytomel during my EMSAM trial (but this didn't seem to result in any improvement).
Strangely, even though I am on my washout I don't feel all that much worse than I did on EMSAM. I tapered down from 12mg to 6mg over the course of a week, and I have gone 10 days without applying a patch. I'm not doing great, but I'm not feeling as badly as I had expected. I'm not sure if that means the medication is lingering in my system, or if the benefit was less than I thought.
Sorry, I wish I had more encouragement for you to stay on EMSAM, I mostly just wanted to vouch for the fact that EMSAM can take a long time before a sudden response happens. I hope my situation is unique and that if/when you begin to feel an improvement that it will be more substantial. I've talked to others on this board who have had much better responses to EMSAM.
Posted by Economist on April 8, 2010, at 14:46:09
In reply to Re: Delayed response with antidepressants? » Economist, posted by em_kath on April 8, 2010, at 14:43:11
lewyfly,
At what week did you notice improvement? Was it subtle or very noticable?
Posted by Economist on April 8, 2010, at 14:47:48
In reply to Re: Delayed response with antidepressants?, posted by lewyfly on April 8, 2010, at 5:26:54
Sorry, the previous message was meant for lewyfly.
Posted by lewyfly on April 8, 2010, at 14:54:47
In reply to Re: Delayed response with antidepressants? » em_kath, posted by Economist on April 8, 2010, at 14:46:09
> lewyfly,
>
> At what week did you notice improvement? Was it subtle or very noticable?After about 4/5 weeks i felt as though some of the anxiety had reduced and the ruminations had lessened although i still felt unstable and with a long way to go. Even still I was optimistic, but now the wheels have fallen off and not sure why.
Thanks.
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