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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by grazce on May 6, 2008, at 2:17:46
I have been on the EMSAM patch since October. I started at 6 mg and was able to go up to 9 mg in March upon finding a sleep/insomnia solution - which is to take 1/3 of my sleep meds ( that I was already taking) a couple of hours before I want to go to bed and then take the rest of the sleep meds and apply the patch. I was/am also removing the patch after about 18 hours so I have some "down time" before the next patch. I really don't know if this provided help in the transition to sleep, but I can say that at this point I am able to sleep fairly well, and at least fall back to sleep when I wake up at night.
I have to be extremely cautious with caffeine intake, which has caused sleep problems for me in general as I get older. EMSAM makes it even more of an issue.
I knew I was feeling better on EMSAM but it was hard to access or articulate to what extent. And then I had to go off of it in anticipation of surgery ( which hasn't even been scheduled yet - but with a 10 day washout I wanted to be ready).
And that is how I discovered that the EMSAM patch was really doing it's job -so to speak - as I tumbled into an inconsolable depression after being off the patch for a week.
Now I am back on it and feeling almost OK.
Besides the (now) obvious to me, treatment of my ever so resistant depression, and now that I have the sleep issues a bit more under control, I have to say that the best part of using this patch after the "getting used to it time period" is the lack of the familiar nasty side effects of SSRI's and even Wellbutrin.
I did have sinus problems for the first six to 8 weeks, followed by a nasty urinary tract infection - both lesser known side effects of this drug. Both have since resolved, but I am careful about the UTI issue not coming back as urinary retention seems to be a common side effect with many of the antidepressant drugs.
FYI - I am a slow responder to antidepressant drugs. It took 9 weeks for me feel even minimal relief when taking Wellbutrin.
For sleep I take .5 mg of klonpin (40 hour half life) several hours before bed, and then take .125 to .250 mg xanax ( 6 hour half life) with 1mg klonopin and then put on the patch at bedtime and I read for about an hour and find that then I can then fall sleep.
I often wake up after 4 to 5 hours, but now I can fall back to sleep, which I could not do when I was putting on a new patch in the morning and keeping it on all day and night.
These problems may have resolved themselves over time without my intervention, ( found the- put on the patch at night advice - on a website (here?) which helped me to be compliant in taking this med - and to discover it really does work for me - as I learned to appreciate in the last week to 10 days.
Posted by Phillipa on May 6, 2008, at 11:34:32
In reply to EMSAM patch, posted by grazce on May 6, 2008, at 2:17:46
Congrats and never knew that urinary retention was a problem which is sometime I have. The patch is something I'd wanted but my pdoc said it was too activating for me. Well congrats again you have your med. Phillipa
Posted by Phillipa on May 6, 2008, at 12:57:05
In reply to Re: EMSAM patch » grazce, posted by Phillipa on May 6, 2008, at 11:34:32
Also see by the green next to your name that you are new to babble Welcome a wealth of information here and seems you also have so much to contribute. Phillipa
Posted by BrightEyed+Blueberry on May 8, 2008, at 0:33:31
In reply to Re: EMSAM patch, posted by Phillipa on May 6, 2008, at 12:57:05
Hi I'm new too. Started EMSAM 6mg six weeks ago and posted my response here. It worked right away for me. And I'm a minimum 8 weeks-to-responsd-er, typically.
I felt the positives - more energy, motivation, the ability to go-out-and-DO without letting my feelings overdictate what I did, you know?
It almost *makes* me exercise. And I'm a firm *I don't like exercise-er*--with a 3 year 24-hour Fitness membership paid up front that I then used only once or twice thereafter! (that was about 5 years ago--however, the plus side, is when I did go back in one of my very occasional bouts of "I'm going to start exercising," I found my membership is $20/year for the rest of my life. NOt per month, per YEAR! That was cool....)
I feel like I have a cold all the time, or maybe allergies...could it be the EMSAM? It didn't dry me out like some meds, and it's not like PRovigil (just that-day suspicious sniffly). But I feel I'm getting over that (so hard to tell, it being spring/summer in California, and me being out and about suddenly and so much with my toddler, and in swimming pools, you know)
I'll watch out for the UTIs though. I have found myself drinking more water....but in general I'm regularly and consistenly doing the things that are good for me - like taking my daily vitamins, calcium, and fish oil...exercising, drinking water..."the boring stuff" of life, I used to think...now I feel like it's life's sanity--stability, peace, serenity. Calm.
Anyway, it's late, I should take my own adivce, get OFF this computer, and read my book to sleep. And take my patch off!
(interesting timing, putting your patch on before you go to sleep--it's a thought to hold on to, you never know how your system is different than others. I had to take provigil exactly 2 hours before I wanted to feel it - though it really hardly worked. And Wellbutrin--had to take it precisely at the time I wanted to wake up the next morning, and do so consistently--for me it was a great alarm clock. Bing! out of bed! Just a general, OK, done sleeping, bright wake-up what's-next? But not amphetamine-like euphoria, no. For me-normal....And I don't do coffee. Wonder if certain meds would work differently/better on me now? I won't "play," I'll be careful, and anyway, I'm doing well so don't wanna rock that boat!
Wellbutrin worked for energy/alive-ness (horrible word sorry), but mood was still down. Worked within days though. And EMSAM worked right away. Better mood than Wellbutrin. Wellbutrin needed adjunct- it WAS my adjunct. EMSAM seems to have it all wrapped up. I feel I've gotta put in the mental work - CBT-like, to help myself, during this period the EMSAM (any AD) is boosting me to that "capable" level. My Window where *I* can make a difference.
SSRIs - I'm DONE. Had it. Caput. Why else go to an MAOI, you know?
-Bright
***> Also see by the green next to your name that you are new to babble Welcome a wealth of information here and seems you also have so much to contribute. Phillipa
Posted by grazce on May 9, 2008, at 0:33:04
In reply to Re: EMSAM patch » Phillipa, posted by BrightEyed+Blueberry on May 8, 2008, at 0:33:31
I am happy to hear you are a fairly quick responder. You are lucky in that respect.The motivations or near motivations you speak of are just coming my way, and I have been taking EMSAM for a little over 5 months.
My bottom line message is - don't give up!
For so many who have been treatment resistant it is hard to hang in there, but what are the alternatives at this point?
Ask your Dr. to help with the sleep problems if you have them (seems to be the major side effect problem and certainly was mine).
As to feeling like you have a cold all the time I experienced sinus problems for quite some time after I started taking EMSAM and a "runny nose".
It just seems to have disappeared - but I would like to understand the connection.
Do watch out for the UTI's. Mine was a sudden onset, but looking back I realized I was not responding to my bodies messages in a timely manner.
As far as other side effects go, after experiencing all the various SSRI reactions, EMSAM is somewhat of a gift, in that you might find it so much more tolerable you can take it long enough to see if it really works for you.
Another advantage to this patch is the ability to control the dose yourself.
Either by cutting the patch or monitoring the number of hours you wear it each day and working up to a therapeutic dose/time that works for you.
So maybe a slow start ( half dose - 3 mg) for some, and fewer hours, might be a good way to deal with "activating" issues.
(Thinking as I type I found Wellbutrin to be activating and
caused me a lot of cognitive dysfunction. And although it kept the depression under control, I found that for me it never really gave me more than band aid relief.)My doctor agreed to prescribe 12-mg patches that I could adjust from 3, 6, 9 and eventually, I will likely take the entire 12 mg dose.
Certainly a lot more cost effective if that is an issue, and I can't imagine it is not for most.
And the only real concern is making sure your measurements are consistent so the dose is consistent.
A cut patch seals itself completely if that is concern.
An aside, I have been reading this forum for well over a year and it was instrumental in my decision to try EMSAM.So thank you all very much for sharing your experiences and giving me the courage and motivation to try one more drug.
Posted by BrightEyed+Blueberry on May 9, 2008, at 0:49:59
In reply to Re: EMSAM patch, posted by grazce on May 9, 2008, at 0:33:04
I was thinking being prescribed the 12mg patch might be more cost effective for sure - if I can get my doctor to do it. I'm her first on this med and while she's good or better than most Ive been to for trying new things, it seems like she might be either not believing or experienced or comfortable enough y et believing you can split it in half and have the dosages adjust...she may still be following the package directions to the letter being eithier MAOI-shy or...maybe just EMSAM shy - I'm sure she's MAOId patients before, though how could I know.
Doesn't hurt to ask though, andi see her tomorrow, so why not? Will tell her I had to borrow money to fork over my $500 deductible - which I'll have to do again in....7 months (calendar year) - andi still pay $150/month.
Official literature/publications on cutting the patch and it being ok? Or its experience and word of pdoc-to pdoc mouth?
Gotta get make myself go to bed early tonight according to my sleep war-plan, see if that helps my insomnia! oops, and rip off the patch exactly nOW!
Thanks!
michelle>
> I am happy to hear you are a fairly quick responder. You are lucky in that respect.
>
> The motivations or near motivations you speak of are just coming my way, and I have been taking EMSAM for a little over 5 months.
>
> My bottom line message is - don't give up!
>
> For so many who have been treatment resistant it is hard to hang in there, but what are the alternatives at this point?
>
> Ask your Dr. to help with the sleep problems if you have them (seems to be the major side effect problem and certainly was mine).
>
> As to feeling like you have a cold all the time I experienced sinus problems for quite some time after I started taking EMSAM and a "runny nose".
>
> It just seems to have disappeared - but I would like to understand the connection.
>
> Do watch out for the UTI's. Mine was a sudden onset, but looking back I realized I was not responding to my bodies messages in a timely manner.
>
> As far as other side effects go, after experiencing all the various SSRI reactions, EMSAM is somewhat of a gift, in that you might find it so much more tolerable you can take it long enough to see if it really works for you.
>
> Another advantage to this patch is the ability to control the dose yourself.
>
> Either by cutting the patch or monitoring the number of hours you wear it each day and working up to a therapeutic dose/time that works for you.
>
> So maybe a slow start ( half dose - 3 mg) for some, and fewer hours, might be a good way to deal with "activating" issues.
>
> (Thinking as I type I found Wellbutrin to be activating and
> caused me a lot of cognitive dysfunction. And although it kept the depression under control, I found that for me it never really gave me more than band aid relief.)
>
> My doctor agreed to prescribe 12-mg patches that I could adjust from 3, 6, 9 and eventually, I will likely take the entire 12 mg dose.
>
> Certainly a lot more cost effective if that is an issue, and I can't imagine it is not for most.
>
> And the only real concern is making sure your measurements are consistent so the dose is consistent.
>
> A cut patch seals itself completely if that is concern.
>
>
> An aside, I have been reading this forum for well over a year and it was instrumental in my decision to try EMSAM.
>
> So thank you all very much for sharing your experiences and giving me the courage and motivation to try one more drug.
>
>
>
>
>
This is the end of the thread.
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