The Anxiety Community - Treatment - Medication: Selegiline

feedback Emsam users by pippa

it's a great relief to have found your site. I find the Emsam patch to be of very minor relief but the depression is more than devestateing. worse depression i've ever encountered and unremitting. constant thoughts of suicide from wakeing till being asleep. i wouldn't do it , but can see no other way out;(the compulive fantasy lets me know i do have a way out). Dr. started Emsam patch 6 mg. in december. eventually it stopped crying jags and relentless detailed suicide fantasies.Emsam raised to 9 mg and minute amount of mouring ritalin added when each weekly visit to the psychoparmacologist was spent in tears shamefully hopeless.I had been on 40 - 80 mg slow release ritalin a day over ten years with no depression experienced the entire time.I relocated and my doctor changed.Controlled substances are treated like contraband in different states.The Emsam patch offers great promise, and i was very hopeful but 2 months on,the devestation still dogs me and all of life is unbearably painful.any personal experiences about the Emsam patch activateing the brain after 2 months on the medication; and hopefully has anyone experienced it actually kicking in? I have no trouble sleeping - i sleep to much, and only eating sweets seems to lift my mood temporarily. the depression is so bad i would buy street drugs if i could find them. i know no such people and never have. should i tell my doctor? (Mon Feb 25 0:22 2008)

Selegeline by nobrot

I have stopped selegeline twice, it was tapered off over a couple of weeks (Sun Sep 9 13:55 2007)

EMSAM by broncosgirl

Has anyone had any serious withdrawal symptoms after discontinuing EMSAM? Has anyone stopped cold turkey? Or is it better to taper off? I had serious withdrawal symptoms after stopping Cymbalta cold turkey and I am worried about discontinuing EMSAM. (Thu Dec 21 11:59 2006)

EMSAM by pris

am going on emsam soon after 17 other drugs and hoping not to have sweet cravings as i did with Nardil. for 7 yrs i was wonderful but gained 150 lbs. avg. wt. usually 115. off now for a year and lost most of the weight. but an freightened. being fat contributes to my depression. anyone have sweet cravings on EMSAM ?
Have also had ect - lost much of my memory (Thu Dec 14 15:19 2006)

maurice by worriedGirl

When I went off effexor, I got the "electric" shocks too. It felt sort of like a bullet exploding in my brain. Chaotic, scary, painful. Suggest you take vacation or sick leave from work to try to get through this, unless it distracts you and helps you more than staying at home. I finally gave up on emsam; doctor thinks I gave up too soon - after 3 wks. I went back on my "last-ditch" line. I'm now on 30mg Remeron. It works, and fast (need to start out at 15mg and build up for about 3 days; at 30 start to really notice effects). Side effects have kept me from going back on it for years - dry mouth, constipation, and weight gain. First two can be handled. The weight gain is problematic as I am already too heavy. It causes you too not feel "satietated" so you want to keep eating all the time even when you are overly full. If you can control that, your half-way there. The other thing is that it makes the muscles feel heavy so that it is more difficult to exercise - like legs feel heavy when walking or climbing steps. I'm working on getting in better shape and hope this will get better but if you get to your wits end, I suggest this. Also there is more "lazy(? not sure if that is exactly how I would describe it)" with it in that my mood is good but I also feel like I am enjoying just lying in bed; you have to make an effort to get up and moving. (Mon Dec 11 16:20 2006)

emsam by joe

newbee i justed started on emsam you indicated it works for you thats great couldyou tell us dsage your on. (Sun Dec 3 17:44 2006)

emsam by maurice

i really hope emsam works.my life is miserable im fighting addiction as it is i cant even make my meetings.i took off work i dread going tomorrow i wanna die but i dont....please help (Sun Dec 3 13:14 2006)

emsam by maurice

coming of effexor made me wanna kill myself damn electric shocks.i hope emsam works..im on it 4 three days now and my deppression hasnt lifted yet im so nervous i cant work i feel like im screwing up a good job i wonder why god does this to me (Sun Dec 3 13:11 2006)

emsam by maurice

i just started itcoing off effexor i wanted to jump off the roof with that electric shock inmy head uuuughghgh (Sun Dec 3 13:09 2006)

wondering where I am going next by worriedGirl

dropped emsam one-wk ago. Struggles at first - withdrawal. Panic attacks aren't as bad but I am taking xanax & klonopin again. Then started feeling better physically. Body didn't feel as heavy as lead as before. This helps mood. I am away from home this week visiting my neice & her 2 kids, so this is an atypical week emotionally. Leave Friday nite. Am wondering how I will feel emotionally sat or sun or mon. being forced to be around people can distract from depression and the fact that the body isn't as leaden, have been able to get through so far with help of concerta and xanax. Also, not all emsam is out of system and may be sustaining me. Next week will be more "telling". However, I don't know where to go from here. Have talked about remeron for a while just to get a respite from feeling so bad for so long - been in a down cycle for a year. I have decided to not start remeron til I hit near rock bottom - as long as my body from neck down refuses to move. However, if I do go back on remeron, I don't want to do it for more than a couple weeks. Where I go from there I don't know. This brief experience with MAOIs is enough and I dont want to try others. Since the emsam provided very little emotional relief and no physical fatigue relief, I'm thru with it because the other problems with drug-drug interactions do not make it worth the try for longer periods. Not willing to go back on to the previous cocktails of the SSRIs + wellbutrin + other anti-psychotics or shizophrenic drugs. Not ready for ECT. Need my short term memory and motor abilities for next few months to pursue lawsuit against my employer. Also, my short term disability is running out in a couple months. any other alternatives.
ps. I really appreciate all the dialogues from people on this sight. It's the only thing I look forward to anymore or that gives me "hope" (? - eve tho sounds like many others are also still on the borderline). Maybe my next regime will be a steady day of tranquilizers - xanax - but whether even that will allow me to get anything accomplished in a day is hard to believe. I don't want to live the rest of my life doped up. I can't give up - none of us can, we have to keep trying - please no suicides from anyone!! But once in a while, you need to have a few days of feeling "joy" just so you don't forget why we keep trying. However, I don't know what to do anymore to get even a temporary break. I'm not a religious person (though am one of the best "christians" I know - as far as being good and caring about other people) so I am/can't/ don't feel like I can rely on god's help to get me through. I think he set the world in motion, gave us some advice, and is letting us humans slug it out - hope this doesn't turn people off. I just wish I felt good enough to start a yoga or meditation program, that that might help me move from negativity to "hope" or optimism, but I'm so down, I can't get me to do anything for myself. And as all my psyschiatrists and therapists keep telling me, I cannot just count on finding a pill that is going to do it all. However, I need a "pill" to at least give me a little juice through the system to be able to "help myself". Anyone out there found any "alternative" medicines that help? love to all you caring people and hope you have a mate/partner that can help you get through some of these things. (Fri Nov 24 2:25 2006)

hold on by mbpmbp2

worried girl
i feel like i am in the same predicament as you and yet
when i see how you feel in writing i want to comfort you
and and tell you that' every thing works out in the end and
if it hasnt worked out it isnt the end'
sometimes when i read that line it makes sense and i can
get through for just another day which is really what
needs to happen--- day by day
every one keeps on saying its about 4 to 6 weeks on the
em sam
if you can see the the'future possibilities', thats a real step
, i know making it happen is so much harder but the mere
fact that you can visualize it is so very important.
we just have to believe it will get better, because it wasnt
always this way, was it? (Mon Nov 20 20:58 2006)

bee by worriedGirl

Mind mind feels like it is going to explode. Went bck to xanax (.5mg 2x/day) in daytime and klonopin at night. Also doing 36mg concerta in morning. First day of stopping emsam and took xanax, had a "high" feeling - saw lots of opportunity for my future, but body didn't have the energy to get there. day 2 off wasn't bad, but day 3 (today) i am having absolutely no energy. I cannot take this. my mind feels reeling out of control and panicky. I just want my body to stop feeling like a lump. Prior experience: no meds have ever totallly helped this - only high doses of concerta (haven't tried aderall) but takes at least 2 hrs in morning for it to kick in. then can't sleep at night and take klonopin which may cause the slug feeling in am. Now I am trying to stop klonopin and use xanax instead and hope don't have as much a slug feeling in am. I am at a breaking point. I am ready tocommit myself to hospital. If I don't get some things done now, will lose job opportunities, house, etc. and don't have energy to handle prep and selling of house. I have given up hope this feeling will ever pass. Am surprised that I am recently getting over tilting event at work that put me off on disability 7 mths ago and now see other future possibilities but cannot due them cause I cannot get off the couch. No where to go with meds. triec 9 mg for 6-7days. Made me irritable and possibly more depressed - could go back to trying 6mg patch but got no physical (energy) lift - from either actually. (Sun Nov 19 20:13 2006)

? by bee

So... are you taking any other medications? Klonopin? etc...? (Sun Nov 19 14:56 2006)

QUITTING TO WORRIED GIRL AND BEE by MBPMBP2

i live in hope until proven other wise
i am on week 4 but am giving it til week 6 if i can
survive that long - 12mgs
bee- no boost if anything the lethargy is worse
i found some old aderall and took i/2 pill which
helped a bit
frankly cocaine seems to be the only thing that
gets me out of the house and i can only use it
when i absolutely have to acomplish something

(Sat Nov 18 23:58 2006)

QUITTING TO WORRIED GIRL AND BEE by MBPMBP2

QUITTING by WORIED GIRL

? by bee

hi worried.
if there is one thing that I have learned over years of drugs legal and non-legal, it's they effect everyone differently. Even still, I am always surprised when someone else has such a different experience than I do on any drug. I'm amazed that you don't feel the energy burst. Are you taking the 9mg patch? Try taking an extra 3mgs. See if that makes your heart race a bit and boost your energy. It should act as a slight stimulant as it boosts levels of norepinephrine. Are you taking anything else at all? What else...? (Sat Nov 18 21:16 2006)

ready to quit by worriedGirl

I don't think I can take this any longer. Yes, it's only been 18 days,but I'm ready to give up. I am thinking of going back to 30mg remeron. If I get same reaction as before, I felt "happy", but so many side effects - mostly fatigue and weight gain. Right now, I'm ready to swap this for awhile if I could just have a small respite. I guess I'd rather feel "good" and fatigued than mostly-depressed and fatigued.
Is there any one out there who feels I should give the patch more time? Help! (Fri Nov 17 15:35 2006)

worried girl by mbpMBP2

i dont know how long one can be patient
if there was any feeling of improvement at all i think i could
try, but this is just insane
if you do feel even slightly bettor stay the course
(Wed Nov 15 18:58 2006)

mbp2 by worriedGirl

Yeah, shrinks always say that! I have been on emsam 16 days now. I was on 6mg patch 10 days - only small mood improvement; no energy. Been on 9 mg 5 days; mood is better but still no energy. I have also noticed some things others have mentioned - highly erratic day-to-day swings while adapting to higher dose. For example, one day ok, next day feel physically horrid - headaches, bodyaches, crying jags, can't move. next day better. I have read that it takes about 5 days after uping the dose for this to "even out"- though there is still always that caveat of "3-4-6 weeks" of reaching full potential.
I have gotten an ok from my doc to add some concerta. 5 days ago started adding 36mg concerta. Have been watching my blood pressure (BP) and has only very small affect on it so it seems to be ok for me to mix the two. the concerta does help give me a little more energy - still have a tired feeling but has given me about maybe 3 hrs in the day in which I can get a few simple things done - like answering mail, dishes, small errands. May try to up the dose but doc won't give prescription for higher dose and so will run out sooner and it is a triply-controlled substance and so can't get around doc knowing I've upped it myself.

I know it's only been 16 days for me,but it is so hard to "be patient" as docs say because this fatigue has been going on for more than 7 mths. How long can someone be patient when their life (or lack thereof) consists of lying on couch feeling anxious about everything that's not getting done and losing out on opportunities because of this. (Wed Nov 15 17:13 2006)

emsam by mbpMBP2

i dont get it, my shrink told me this worked for every one
i am so much worse this- is my 4th week- any body have a
clue -can you go higher than the 40 mg patch-how much
longer do i give this i am barely leaving my house and am
huge (Wed Nov 15 15:13 2006)

Emsam & sleep by wtmdmm

I had the same problem w/ insomnia while on Emsam - no sleep med I tried helped much. I had chronic insomnia before it but it did exascerbate it alot.

It seemed to "invigorate" me too but didn't really improve my mood or energy level that much. After a few dizzy spells during the rare times I've been able to exercise & feeling as if my blood pressure was being affected I stopped it (cold turkey as I was becoming afraid to remain on it!). I'd advise anyone trying to go off it to cut the patch & taper off it. It's been over a week & I'm still adjusting....a rough week.

As for most people Emsam was my last ditch effort - tried all the other anti-depressants & they haven't worked either. No sleep med's work very well either - tried them all too. Presumably if something fixed the depression the sleep would follow & perhaps vice versa but none do.

It IS a very frustrating way to have to live (or in my case NOT really live). You just have to keep trying...what else can you do? (Mon Nov 13 23:15 2006)

SLEEP by MBPMBP2

Up to 12mgs of the emsam
i fall asleep at 6 or 7pm , just cant keep my eyes
open and then up at 9 til 2/3am
this stuff seems to have the opposite effect on me
no energy-dont want to get out of bed in the am
and cannot loose a pound
never want to leave the house/talk to any one/
get dressed
feel like i am evaporating (Mon Nov 13 23:11 2006)

So nice not to feel alone - Thanx by Carolynn

It's so nice to have this place to come to where there are people who understand what I'm going through because they're going thru it themselves, or have gone through it before. I appreciate everyone's posts. They validate what I'm experiencing, and give sage advice from a "been there, done that" perspective.

Sometimes my shrink looks at me like I'm just making this stuff up and that pisses me off. Here, I know that you know that what I'm experincing is real. And, difficult. And, frustrating.

The Restoril is a bust. It gets me to sleep for an hour or two. But, then, I get up with my mind racing. I'm going to cut the patch in half and see if that'll control the depression, but make it easier for me to sleep. I think the full patch is too "invigorating" for me. Can't seem to turn my mind off when it's time to go to sleep.

I started out this way, because the full 6 mg. patch made me insane. Moved up to the full patch because I was getting some breakthrough depression. I might just have to accept feeling "good", instead of "great"!! I might have to be more accepting of some depression every now and then.

This "experimenting" is hard. Hard on the mind, the body, and the soul. I'm trying to have a more accepting attitude, because if I sleep like c..p one night, I do zonk out the next and get a full nights sleep. Thank goodness for that!

It's frustrating, though. Just when I thought I was going to have a better life because of the patch, it causes my sleep to go to hell in a handbasket. I hate having to live my life around my mental health issues. And, I've got a lot of them.

I'm gonna see how things go with the half patch. Wish me luck. Thanx again for caring enough to write. C
(Mon Nov 13 7:04 2006)

Carolynn installment #2 by worriedGirl

Carolynn, this is a continuation of the message below, so read that first then come back to this one.

I haven’t tried Dalmane but it is in the family of benzodiazepines and from what I have read about it, it sounds like it stays in the system for a long time and sounds to me like it could make you tired the next day – but I really don’t know; you might have to try it to see. All I know is that as long as I have been seeing psychiatrists, they have never suggested Dalmane. They have also never suggested Ativan. I have taken Ativan, but it has usually been prescribed only for me to take the night before an operation that would be done under local anesthesia. Ativan puts you to sleep and it also made me feel “happy” the next day. But I think I have heard that it’s even more addicting and thus harder to get off than xanax.

From my experience, there are no good drugs out there for insomnia – all have some bad side effects. I have been on 1mg klonopin for a couple years and, though the same thing – “getting used to and needing more with time”, I have not had to increase that dose. As I said above, some nights I am to hyper and it doesn’t work, but I no longer take ambien to get to sleep. Either I let it go and decide if I am up all night, so be it. I do not have a problem going to sleep the next night. Sometimes, if I am really anxious and can’t stand it, I will take a second klonopin and (since it is slowly released) will go to sleep in an hour or so. However, the next night I go back to just one klonopin so that I do not get my body addicted to needed two and I am usually ok. It takes a while of upping the dose for your body to get addicted to the higher dose.
(Mon Nov 13 3:27 2006)

Carolynn by worriedGirl

I’ve been on the 6mg patch for 12 days and then up’d the dose to 9mg patch because I wasn’t getting much antidepressant effects. Only been on the 9mg dose for 2 days but already feel better. I have actually been sleeping better on the patch but that may be due to the fact that I have been taking 1mg klonopin for quite some time for insomnia while on other types of antidepressants. Since I have been on klonopin for so long, I cannot just stop taking it – any benzodiazepine must be tapered off. For example, xanax is also in this family. Stopping these stone cold can cause withdrawal effects that can kill you. I don’t know if I would have insomnia without the klonopin – i.e. if I were just on the patch. So I will taper off it when ready. Dalmane is a benzodiazepine also. That means that you will become addicted to it – meaning withdrawal symptoms. But I have gotten off both xanax and klonopin in the past when I didn’t need it. This was when I was on tricyclics – no insomnia prbs; always had insomnia problems on SSRIs and wellbutrin.
Xanax is faster acting than klonopin and shorter lasting. Klonopin is slowly released in the body, so takes longer to put me to sleep than a large dose of xanax. However, klonopin is easier to get off than xanax. So with klonopin, I usually take it 2-3 hrs before bedtime. Relaxes and helps sleep. However, it sometimes doesn’t work. Depends on how upset I am that particular night and what other drugs I may have taken. I was also on concerta (methlyamphetamine), and that makes it harder to get to sleep. So, on some of these nights I would also take ambien.

Before the benzo’s to help with sleep, they tried my on ambien, lunesta, trazodone, remeron, temazepan (restoril). I have also been on topamax and seroquel, but not for the sleep problems.
Topomax was for headaches. Made me tired – helped to go to sleep but was also on klonopin at same time – but it made me nervous, anxious, and terribly depressed the next day – even on a low dose. Will not take it again.
Seroquel – bad news. Bad reactions. Won’t take.
Trazodone – puts you to sleep but totally drags you down for the whole day and made me feed extremely depressed – even though it’s supposed to be an antidepressant. It made me feel so awfully tired and depressed and gave heart palpitations. Advise everyone to stay away from this drug.
Lunesta and restoril did not work for me.
Remeron – was on a low dose just to help me sleep – like 7mg. Did help but made me tired the next day. Remeron is a tetracyclic antidepressant (TTC). Doc said that it has been reported that higher doses of remeron actually make you less tired –starting at 30mg. I tried this and gave up my other antidepressants. Remeron, at 30mg, was a good antidepressant – felt good on it and slept well. Thought I was less tired than on the lower dose but still was tired enough on it that I couldn’t function too well the next day. Also, you cannot take a TTC with an MAOI.

Ambien sometimes worked for me. Bee didn’t mention what dose the tablets of ambien he was taking was. It comes in 5mg and 10mg tabs. Most docs start you with the lowest –5mg. 5mg doesn’t work for me. 10mg usually did put me to sleep in about 20 min. However, it does cause dependence – as they are now finding out; initially it was advertised as NOT causing dependence. I found that if I took it, it was harder to get to sleep the next night and so had to take it again. This continued til the weekend when I didn’t take it and if I didn’t go to sleep, I didn’t go to sleep, but would get straightened out by the end of the weekend to break the cycle of needing ambien. Also, I was on klonopin at that time. I only took the ambien if klonopin wasn’t working that night. I got terrible headaches with ambien which got worse the more consecutive nights I took it – hence having to take Topomax for the headaches with the side-effects mentioned above.
BIG warning: the recommended max dosage of ambien is 10mg. It is ok’d to take up to 20mg, but not advised due to the possibility of hallucinations. When 10mg didn’t work, I took a second tab – i.e. total 20mg. I did have hallucinations – not quite what you expect. It just seemed to me that I could see shadows of people out of the sides of my eyes. But in a fearful way. I had the feelings that someone was in the house and sneaking up on me. NOT pleasant. It did make me sleep “sort of”. I slept, but lightly because I couldn’t really get a good nights sleep for the first few hours because of these “hallucinations”. In addition, it does become less effective if taken regularly. Moreover, even when the 10mg tab worked and put me to sleep, I never really felt rested the next day. If bee is taking 4 tabs of 10mg, I think that’s really scary; but drugs act differently in different people. If it’s 4 tabs of the 5mg, that’s 20mg and he may get exhilarated from it in a way that I got exhilarated but his was a “ (Mon Nov 13 3:26 2006)

sorry by bee

hi,
sorry for that last post. Ambien had me messed up and a bit incoherient. ment to say in the last sentence...If you need to, take more ambien until it is effective to make you sleep rather than going to one of the atypical antypsycotics like seroquel.
Thanks, (Mon Nov 13 2:47 2006)

Carolynn by bee

I Carolyn, I am glad that the Emsam completely takes away the depression as you say. it does the same for me. I started at 6 and it worked but asked to move up to 9 cause if 6 is good 9 is better right... well yes in this case it has been. I have speeding isses too and also always have. I agree that ambien is not strong enough on it's own, that's why
I take 3. Actually I took 3 about 30 minutes ago ane Im having a very difficult time typeing this. Im hitting backstpace soo much cause Im trying to make this as legible as possible. I actually like the high from ambien and it works to put me to sleep taking 3 soometimes 4. Well, heres my advice. go with the ambien regular preferablly by cr if they wont give you the regular ones. and then just take more than they tell you too. if you feel comfortable tell you doc that you have been trying to take 2 and it is helping. then you took 3 and it actually worked. it is not unthinkable that he could special write a prescrition for you as like me are highly tolerant to it. BUT...... Im glad you read the post about the seroquel. IT is the devil for people like us who are finding success on Emsam. Seroquel is evil. I'm a bit too f-ed up to get into the exact nature of what it does in the brain chemestry in relation to dopamine, but I belliev that I have in previos posts. please read those if you have not read them all.
Again. Please say no to seroquel and the otehr antypical psychotics. they disable dopamine and you will surely be depressed again if you take the antypical psychotics-remeron seroquel. it will happen fast too. please stay away from them. If you need to speed again up dose yourself on ambien. (Sun Nov 12 20:20 2006)

Insomnia!!!!!!!!!! by Carolynn

I've been on the 6 mg. patch for about six months now. Although it COMPLETELY takes away the depression, I can only wear it for 10 hrs. a day because it gives me the jitters and also causes some kick-ass insomnia.

I've always had sleep probs due to anxiety, so I've been taking Neurontin for the last 3 years for that. I know about the tolerance issue, as I've kept creeping up on it over time. But, my shrink's been content to let it happen, indicating we'll beat it back down by switching to something else when the time comes.

Well, the time has come, but he's making noises about Seraquel. I've read in the posts here that taking that with the patch is counter-productive. I tried Ambien, which, for me, was like taking a sugar pill. The Topamax gave me SERIOUS insomnia. I'm talking-up-until-5:00-am-every-night-kind of insomnia.

Now, I'm trying Restoril, which seems to be doing an okay job of getting me to sleep and keepiing me there. Only been on it for a coupla days, though. Behind Door #4 is Dalmane. Anyone had any experience with that? Also, is anyone else having problems with the insomnia? And, two, what are you taking for it? Thanx. (Sun Nov 12 13:21 2006)

adderall and emsam by bee

adderall and emsam is generally a no no because of the hypertension issue. Speed
(adderall) releases lots of norepinephrine
(plus dopamine and a tiny bit of serotonin).
The MAOI - Emsam slows down the metabolism of norepinephrine and increases its effect on the release of the chemical. You could experiment with it (very little at first). Personally, I don't like it, adderall by itself is potent enough. Together with the Emsam, I practically freek out. It's uncomfortable. Plus it has the potential to be dangerous, but how dangerous is different from person to person. You probably could get away with taking small doses of amphetamines with Emsam. And I can garantee you this... you will not be lieing around in bed. And again you will lose weight. (Fri Nov 10 8:22 2006)

weight by mbpmbp2

bee
nope , no other meds,-but i dont think doc will comply with
aderall
also why not emsam and aderall
is it the blood pressure thing-what about small dosages
(Thu Nov 9 10:27 2006)

emsam by bee

Hi mbpmbp2,
Are you taking any other meds in addition to Emsam.

Also, if the weight is the major issue. Try to get on adderall (need to stop Emsam). Adderall is like speed. You'll loose crazy amounts of weight on it, and energy - well again it's speed. Originally it was developed as a weight loss drug. That didn't last long before it went to it's current use. But again - get yourself prescribed adderall. 2 0r 3 20mg pills a day and you'll lose weight like you wouldn't imagine.
Later. (Thu Nov 9 3:37 2006)

weight by mbpmbp2

thanx for getting back
this is really disturbing as i believe my depression is in
part weight driven.
i will diccuss concerta/thyroid(all my test were neg,)
medication with my pharmacologist but i get the feeling
after seeing him on and off for 5 years he is losing
interest
taking a leave isnt an option as we have a kid in college
etc..
menopause is also a factor here and hormone therapy is
not viable due to cancer in the family (Wed Nov 8 18:36 2006)

emsam - energy by worriedGirl

mbpmbp2 - can you go out on disability? If I hadn't that option, I would not have a job either. I have disability insurance as I am my sole support and so have some income. If you do not have such, most companies allow you to go out on short term disability (without pay) and you can have your primary care physician sign it so that they don't know you are out on psych. reasons - reasons for going out on disability are supposed to be confidential anyway. That, at least, would protect your job for awhile. There are laws against firing someone out on a disability leave - they can't do it! Relieving some of that pressure about job can help with the other pressures with husband, medic. frustration, etc. - a bit.
As far as energy, I checked with my pshych. and he said it is possible to take a low does (18mg) concerta with MAOIs - however, you must be closely monitored - use home blood pressure equip to check BP frequently, as can be dangerous combining the two. He will not let me try that yet til I have been on EMSAM longer.
Other suggestion, drop the MAOI and try a tricyclic - vivactil. Other tricyclics worked but made me tired and increased weight a lot more than vivactil. However, it is extremely important not to let them (psych or pahrmacy) substitute the generic - I know from experience the generic vivactil does not work. Most generic anti-depressants are not as good as the brand. Can give references for this.
Also, your docs should have done this but don't always, have tons of blood tests to make sure there are no other problems. Also can add small dose of thyroid medication - boosts metabolism and energy, helped me a little as far as the weight gain even though thyroid tests were normal.
I, also, have been gaining weight on EMSA. Even though this is only day 9, I have put on 4 lbs. (Wed Nov 8 15:27 2006)

emsam by mbpmbp2

3 and 1/2 weeks & i just upped my dose to 12mgs
am not leaving the house,not getting out of bed, not
showering
no energy - how much longer befor i lose my job , husband
mind?
my weight is a major - issue anybody out there with some
suggestions (Wed Nov 8 10:37 2006)

Day8 EMSAM by worriedGirl

Starting to feel some benefits from EMSAM. Don't feel as "weepy" but still have very low energy, though on day 8 have noticed some improvement there. Trying to be patient; anyone care to "share" how their energy levels were affected as time on EMSAM increased? and at what levels of the patch (I'm on 6mg). Thanks. (Tue Nov 7 14:05 2006)

nice job by john

Way to kill the thread worriedGirl. (Sun Nov 5 4:04 2006)

Day3 update by worriedGirl

More investigation in med literature and self-observation, realized recent HDs are partly (or mostly) caused by recent high doses of ibuprofen (prescription strength). Since getting off norco to get on EMSAM, starting using 800mg ibuprofen every 6hrs for recent problems with back and neck (took a big fall almost 2 wks ago and besides screwing up already screwed up neck and back, got slight concussion). Find that ibuprofen, used as NSAID and pain, can also GIVE headaches - just like all the other pain meds can backfire and actually cause pain. It was also causing me to itch all over my upper body - this itching was NOT caused by the patch, was not even where the patch was.

I have always been super sensitive to all meds. If anything has a .01% chance of a side-effect, I will get it. Have even been on meds that have caused bronchitis. Don't leave it to docs to realize this - even though they are supposed to. I was getting bronchitis constantly - came back within a week of each course of antibiotics. I had to do literature search myself (keep diaries to of all meds, time, and how I'm feeling so have track record that just needs to be correlated correctly - don't start more than one med at a time)to find med caused it.
Have also had horrible body shakes that docs diagnosed as "anxiety" because "nothing else", except parkinson's, could be the cause. I didn't think it was anxiety, nor did my psychologist, but docs didn't believe me. So, they kept giving me more of a med to help with the "anxiety" and I kept getting worse. Found out the med they kept giving me more of for the shaking was causing the shaking - couldn't be anxiety as I was starting to practically be in convulsions all the time. I had to figure it out.

Doctors really need to look at the whole picture and do their homework - which they don't, even if it's "their" drug; they only look superficially at side-effects and never revisit less obvious ones even when patient is having problems.

However, now not sure what to do about the severe body pain - maybe it's been enough time since accident, I can get by with just small doses of norco so that headaches don't come back.
(Fri Nov 3 1:49 2006)

EMSAM by worriedGirl

Hi bee. Thanks for info. I'm taking the vicodin, but at low dose. I learned a lesson before (ie pre-EMSAM), that you need to be careful with it. I am/was actually taking norco (twice codeine of vic., half the tylenol - less tylenol is good. Started a couple years ago due to extreme neck and shoulder problems from ergonomic setup at awork - causing permanent damage, and just a word to people, you have no recompense to sue your company for negligence (they didn't want to spend the money, ~$700, for the equip!). I unfortunately didn't know that continuing to put up with it for 4 mths caused permanent damage. So, inititially, norco was for the neck pain. That got better but headaches I was having got really bad - so started taking again for HD (headaches) and started taking more and more cause HDs were only getting worse - eventually found that meds, sinus', were cause and that higher doses of norco actually made HDs worse! Got off it. Then about 2wks ago fell and reignited severe neck and back pain. Additionally, even before that, HDs got really bad again - believe it's mainly due to getting off Effexor - effexor really fights back. Day after my last posting, started taking half a norco (roughly codeine equiv of vicodin), for neck & back pain & some HD relief. Helps a lot to manage the back pain - which should decrease with time.

HDs not totally relieved by ibuprofen and half-norco, still major problem. Going back to see my neurologist next week and going to push hard to find the CAUSE! and something other than norco for the pain. Hoping with start of EMSAM, HDs will get better - especially if they are due to withdrawal symptoms from meds. I get so fed-up with these specialists not talking to each other and refusing to comment on potential affects of meds they aren't prescribing. I want a coordinated approach where ONE doctor will take responsibility (and have the KNOWLEDGE) to figure out what everything I'm taking, eating, doing may interact to cause them. Think I'm dreaming, though. I don't think the medical community is up to that (as you see, I'm rather cynical and disillusioned with docs).

However, day 3 of EMSAM - if didn't have these HDs, things would be better (not EMSAMs fault) - they interfere with feeling OK and being able to get things done. But, I do notice I am feeling a little better each day. I also have brief moments - flashes - of, what I call, things to come. i.e. I've had moments when I'm near awakening in the morning where I experience feelings of "how I used to be" - one's that were good. So I take this as a good "premonition" that EMSAMs gonna work for me; just got to be patient and tell myself that everyday. Meanwhile, I watch a lot of comedy shows on TV and set a goal of getting just one thing done (that needs to be done) a day. (Thu Nov 2 16:23 2006)

vicodin by bee

Hi Worried,
Glad you finally got on the Emsam. How was it for you getting off the other meds?
FYI: I have done minor experimenting with vicodan and percocet on Emsam.
I started extremely low dose. So little that I did not notice anything. Slowly tried a bit more. When I finally did notice the opiate at work, the side effect I noticed was extra jumpy... uncomfortably so. I suspect it is from the norephedrine released by vicodin.
On a side note: The issue with mixing opiates and Emsam is not primarily the increase in dopamine but rather the increase in norephedrine. (eg: parkinson patients take both Emsam and a dopamine agonist like levodopa). The increase of norephedrine in the brain is what causes the hyertension issues with Emsam. I noticed a bit of the feeling and did not mess around with high doses of pain pills.
Mixing pain pills and Emsam is very under-documented but here is what I found and pieced together.
Let me just prefrence this with - I think that it is best in the long run for your depression to stay away from opiates as you really don't want to train your brain to release dopamine when a chemical (pain pills) tell it to - (unnaturally). Emsam works when there is an active supply of dopamine, so you want your brain to produce it. For the majority of depressed people who underproduce dopamine, Emsam is perfect. For the extremely small percentage (dope addicts, parkinsons patients) who's brains won't produce dopamine on their own, they need a dopamine agonist like levodopa.
That being said: a pure opiate - morphine maybe oxycontin, (and not sure about what else) are ok to take with Emsam as they have very little impact on norephedrine. They definately need to be taken less than normal as the dopamine levels will become extremely high in the brain. But nevertheless they should work to kill the pain (and theoretically you should feel really good (high) for who knows how much longer than normal. I would love to try it but as a recovering oxycontin addict (and finally ok again after years now since I got on Emsam) I really don't want to mess with it now.

So if you really need it, then a pure opiate might be the thing. But, good luck convincing any doc these days to prescribe you one.

(Tue Oct 31 22:44 2006)

emsam by worriedGirl

anyone out there taken vicodin with patch? literature says to talk to your doc about it. Mine's not returning calls; may not be able to wait. I have history of severe neck and back problems & headaches. Hurt so bad. Ibuprofen doesn't do it. Anyone else have something they use for similar pain?

Started 6mg patch today. mbpmbp2 - I'm going through similar stuff. I don't leave house unless it's for one of several different specialists I have to see for one thing or another. I am getting so behind in some things that GOTTA get done pretty soon or will be too late.
headaches hurt so much, ready to risk doing vicodin w/o doc. (Tue Oct 31 21:36 2006)

to mbpmbp2 by davis

2 weeks isn't necessarily long enough to tell. First you are having to get over being on other meds, then you have to give emsam time to work.
Hang in there, hopefully you will start to feel progress into week 3 or 4
I know the feelings, its no fun, but I am in same boat but am progressively feeling better into week 4 (Tue Oct 31 19:19 2006)

emsam by mbpmbp2

2 weeks into this with the 6mg patch
gained 7lbs in the 2 weeks i was off all meds and now have
to lose 30lbs instead of the already impossible 20
I never wnt to leave the house and am just a mess
is this stuff going to work (Tue Oct 31 12:32 2006)

headaches by bee

I used to have headaches all the time before emsam, now i dont get them anymore. (Sun Oct 29 3:07 2006)

emsam by worriedGirl

anyone found anything useful for the headaches? (Sun Oct 29 1:03 2006)

bee by emsasm

Hi Davis,
That's great! Glad to hear that you stopped the other counter-productive meds and are starting to see results form the Emsam. I'm 100% confident that the Seroquel and Zyprexa were the problem.
I'm psyched for you! Keep us updated. (Wed Oct 25 19:34 2006)

emsam,lamictil update by davis

After 16 days on patch, here is my assessment.
I think that the deeper valley I hit when I started the patch was the withdrawal from lamactil and maybe using seroquel and then zyprexa in combo with patch. The last two days have added hope to better days.
Is this the patch kicking in? Is it the withdrawal period ending with lamictil?
is it not taking seroquel or zyprexa with the patch?
All I know is based on bee and others I decided to stick with the patch without other drugs and starting my 3rd week on patch I am starting to get a lift from the funk of a fog I was in.
I will post another update soon
I don't have too much trouble with sleep so I am not going to add a sleeping aid to my cabinet. (Wed Oct 25 19:08 2006)

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