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Old 08-06-2006, 01:45 PM   #31
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Re: Has anyone talked to their doctor about EMSAM?

Isn't it always hard to breech the topic of depression? I'm not currently being treated for it, so it would be a new complaint. If I had tolerated ADs well in the past, I'd have no problem bringing it up. But I would have to tell him I'm depressed then say that I don't want to take any meds he normally prescribes. So it's almost like whining in my mind. I dpn't want to seem like one of those pushy know it all patients from the internet and go in and tell the doc what to prescribe, especially if he might turn down my idea.

Parnate caused weight gain? Is that common? I know Nardil does, but thought Parnate was better in that regard.

 
Old 08-11-2006, 12:46 PM   #32
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Re: Has anyone talked to their doctor about EMSAM?

Anyone else hear about this med?

 
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Old 08-20-2006, 06:01 AM   #33
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Lightbulb Re: Has anyone talked to their doctor about EMSAM?

I am on Emsam 9 mg now, have been since June. I've had a severe complex depression for 3 years now, treated with numerous SSRI's (4 at the same time before I got the patch) I was nonfunctional, isolated, crying daily, no social activities. After 4 weeks on 9 mg i started feeling motivated, normal people feelings - it was exciting and wonderful. I had a setback in depression by a medical condition hospitalization and 4 week recovery, but slowly i have returned to my motivated state. Emsam has been a blessing. Sure there are lots of drug/food restrictions but i can manage those for the chance to live a productive life again. The unfortunate part of the Emsam for me is that I have a rather severe allergic reaction to the patch. There are 8 sites to place the patch, changing daily. However I am currently treating 12 sites with cortisone (placing the patch beside nearly healed sites) My allergic reaction is itching, redness, burning. The site of the patch for that day itches alot, site of the previous day is very red, burns, itches some. I have a long history of depression and treated very successfully with tricyclics and SSRI's over the years; but for the last 3 years nothing was successful. tricyclic before this 3 year drug resistent depression started worked for 14 years! However I gained 40 lbs. I started losing that 40 3 years ago with 10 lb first year, 10 lb 2nd year. With Emsam I 've had rapid weight loss - just no appetite. I've had problems with insomnia over the years with depression; but since Emsam I'm up most every night all night (it's 5:40 am now) despite 6 mg of lunesta. I do get 4 hours good sleep when I go to bed between 5:30 am and 7 am. I'm retired so fortuntely i don't have to try to hold down a job with this insomnia. To sum up, Emsam is working well for my depression; i can manage the 50+ food restrictions - can I manage this allergic reaction much longer? I don't know. My psychiatrist says there isn't anything else out now for me - I'm between a rock and a hard place. I see on some message boards depressed patients are using Emsam (selegiline) 5 mg oral but it's not available in the US yet; I don't know if US doctors might be prescribing and patients ordering from Canada, etc.) 5 mg is available in the US in a compaound for Parkinson's patients. also read about patients cutting the patches in two, using for 10-12 hours instead of 24. This might help me. My doctor knows nothing about this; and isn't interested in finding out. I don't want to discourage you from the patch if it would relieve your depression; and you might have no allergic problem with it. Good luck lulu

 
Old 08-20-2006, 07:49 AM   #34
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Re: Has anyone talked to their doctor about EMSAM?

Wonderful that it's working for you!

I actually was thinking recently it would be a good option for me because the one thing I can think of that improves my mood is coffee, which contains large amounts of caffeine (like the amphetemines produced by selegiline) and causes Dopamine activation (like MAOI-B's). I also have mild inattentive ADHD, so this would improve my concentration as well, plus give some much needed energy for the 8-12 hours of classes (straight!) per day starting soon!

How much weight have you lost now? Did you ever gain on SSRI's? That's my biggest concern!

I had a physical last week. I told him about the insomnia, the Lunesta had stopped working and I've been sleeping 2-3 hours a night at school. I told him that I reluctantly experimented with stopping my Straterra for 5 days in efffort to help with insomnia. Since restarting, my depression has increased and I cry all the time.

He actually seemed a little stunned, since I act like a happy little ray of sunshine and enthusiasm when we speak I'm glad I brought it up. Right now I think he's sorta hoping it's attributed the odd med reactions and lack of sleep. I know this is untrue, but so proud of myself for having the guts to bring it up.

While he was "thinking outloud" after I told him all this, he said something about I wonder if we could try Celexa or something if, I wonder if it could be depression... Haha, seriously the guy thinks I'm too happy and successful to be depressed (even though I suffer from major anxiety, insomnia, ADHD, and have had depression in the past!). I was like umm yeah... but I've never liked any of the meds we've tried in the past (Wellbutrin, Paxil, Buspar, Effexor), so I'm not so sure. He agreed, not wanting to force an SSRI on me when I've always hated the side effects of all related meds.

Well, the Lunesta was increased, but it's not helping. I need to go back to see him about that. We stopped the Straterra altogether, hoping to ease the "mood swings", but I know better. It won't help. So, I must go back to ask for something different for the insomnia, and reiterate my feelings of depression. It'll be about 2-3 weeks from our last meeting, enough time to rule out adverse med reactions. I definitely want to mention that coffee helps, because I'm fairly certain he'll realize it's a dopamine problem, since stimulants cause a dopamine release. He may actually think of a stimulant, like Ritalin, esp. since I have some ADHD issues. This could help, but I'd really like to try EMSAM.

 
Old 08-21-2006, 12:59 AM   #35
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Re: Has anyone talked to their doctor about EMSAM?

Lulu...

I'm not sure of the purpose of the quote you just posted. Was this directed at me? Or did you just want to bump up another poster's experience for some reason, which you forgot to explain to the rest of us?

 
Old 08-25-2006, 08:44 AM   #36
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Re: Has anyone talked to their doctor about EMSAM?

Lulu,

How are you doing with the EMSAM? Are you still taking it? If so, how's it helping with the depression?

If you're having problems with an allergic skin reaction, I'd suggest seeing a dermatologist, an allergist, or both. Success with an AD is worth making an extra effort to counter side effects.

I'd wonder what your actually allergic to. It wouldn't be Selegiline, most likely, but something involved in the patch formulation. Maybe you could have a cutstom made Selegiline patch through a compounding pharmacy.

 
Old 08-27-2006, 09:46 PM   #37
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Re: Has anyone talked to their doctor about EMSAM?

Quote:
Originally Posted by BorkBork
She hadn't heard of the drug before, and no, I didn't force her into anything, I brought her the prescribing information, which I obtained from the manufacturer's website and told her up front that my intention was not to put her on the spot, and told her that if she wanted to take some more time to learn about the drug and not prescribe it right away, I was happy to let her do so. She said she didn't think she would have any problem with it but nevertheless wanted to go to her office for a moment to briefly read over the materials I gave her as well as check her own information, presumably the bible for MDs, and when she came back she said she would prescribe it for me. I was surprised that she prescribed it to be honest.
I'm surprised a doctor would be so humble. Admitting to not knowing about a new drug and its indications takes some guts. Prescribing it on the spot does as well! This is partly why I'm hesitating to discuss EMSAM with my doctor. I fear that either he will be against an MAOI, or that I will catch him off guard and he won't know enough about the medication to be comfortable discussing or prescribing it.

I know they tend to like to give out medications they have samples of. I know they don't have samples of EMSAM. I wonder if the EMSAM reps have even started making rounds yet. If so, it would most likely be would pdocs, not family practices.

 
Old 08-29-2006, 12:17 PM   #38
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Cool Re: Has anyone talked to their doctor about EMSAM?

Hi, I started the Emsam patch in the last week. I must confess, being very leary about the side effects, I am currently cutting the patch into smaller but equal pieces as a precaution until I feel OK with this med. My doctor is giving me samples, so yes, it is available to Psych docs as samples. I am taking it for SA (Social Anxiety disorder) not for depression although many times my SA causes such dysfunction and stress in my life that I sometimes feel depressed. The one thing that stands out so far, in the few days I have been on such a small dosage( 1/4 of a 6 mg patch= 2 mg/day) is that I have insomnia. Even my valium, which I would sometimes take when woke up in the middle of the night, is not working on this stubborn insomnia. So I have been averaging about about 5 hours sleep now and I have been waking up a little later than usual. Fortunately I don't need to wake up early. I am now taking the patch off at about 6:30 pm and putting it back on in the morning. This seems to have helped- because at first I was awake almost the entire night, now at least I can sleep most of the night. I always felt I was more sensitive to meds side effects, which may or may not be true. But I tried many of the SSRIs in the past, mainly for my co-existing hoarding OCD disorder and I found that no matter how low a dosage I took, the SSRS's would cause me to sleep up to 16 hours a day! So they were just not a practical option for me. Since both the SA and OCD are about equally as debilitating in my life, I am very determined to find the correct mix of medication and therapy to help me. I will try share my experiences on Emsam over the next few weeks and would love to hear from others who are using it. The full 6 mg patch is supposed to bring results in 2 weeks.
RonneeGirl

 
Old 08-29-2006, 05:33 PM   #39
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Re: Has anyone talked to their doctor about EMSAM?

Thanks for sharing! I have social/general anxiety too, so I know what you're going through, although I'm actually interested in EMSAM for its antidepressant properties. While my anxiety does cause me to be unhappy at times, I also am prone to major depressive episodes, unprovoked by SAD or GAD. I think that stimulants are good for people with SAD. It gives you the energy to be more social. I know I used to feel horribly drained of energy after social encounters and always felt the need to recouperate. So I'd say stick it out as long as possible. The valium will help calm you down, the EMSAM with give you the stamina you need to get out and stay out and interactive in this crazy world we live in!

I sympathize with the insomnia as well. It's terrible to deal with, but you seem to be doing OK. If it doesn't subside, I woudn't hesistate to ask you pdoc for a sleeping med. Unfortunately, sometimes side effects do need to be treated with additional medications in order to keep the primary ones on board. Does your doctor have high hopes for EMSAM or any other patients on it? If it helps with your quality of life, keep trying for new and better medications that will help you be at your best!

Please update with your progression. I'd love to hear it!

 
Old 09-01-2006, 03:52 PM   #40
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Smile Re: Has anyone talked to their doctor about EMSAM?

Hi again,
I have been on the Emsam patch for a few more days since my first post. As I mentioned earlier, I am taking it for Social Anxiety Disorder.
I am quite certain now that the med is making me hyper. My insomnia remains, and I now have noticed that my appetite has decreased considerably. At this rate, I will be losing weight rapidly. I have very little appetite before dinner and then I don't eat much at dinner either, like I sometimes do. But I am still only on 1/4 of a 6 mg patch!

I took my dog for a walk today, and found that I had super energy and walked very fast. I could feel the muscles in my legs burning as I walked.
Right now this is OK because, before normally I have trouble losing even one pound, even though I am not really much overweight-just more out of shape.
It couldn't be more of an opposite reaction from what I had on the many SSRI's I tried previously for my OCD, which made me sleep endlessly and slowed down my metabolism! I wish I could find something in-between.

One thankful note: So far, I've had no problem with skin irritation at all using the patch.

But I do feel groggy right now- it is 6;30 pm Friday -yet I doubt that I could fall asleep even if I tried to take a nap. It's kind of a strange feeling -to be tired and wired at the same time. -An over-tired feeling.
As for diet, I found myself not heeding any dietary restrictions due to my self-regulated very low dosage of 1.5 Mg/day. I did feel some heart palpatations a couple of days ago after eating chinese food mixed with pepper steak- both were drowning in soy sauce. So I think I will avoid soy sauce in the future. I have been eating cheese, but not very aged. Just American, brie, and mozzarella (on pizza).
I'm really not worried about the high-blood pressure reaction because I normally have extra low blood pressure- although I haven't checked it since starting the EMSAM patch. I have not felt dizzy at all either, which is also a possible side effect.
My pdoc was ecstatic when the patch came out. He raised his fists in triumph, so apparently he thinks the medication is very worthwhile and is thrilled that the patch allows the med to bypass the GI tract therefore making it less dangerous than the pill form, (at least in the lower 6 mg patch dosage).
However, if the insomnia doesn't go away or at least lessen, I don't think I will be able to stay on EMSAM, since I don't think it is healthy to be awake half the night.
But I'll just continue to see how it goes for now, taking it one day at a time.


 
Old 09-01-2006, 06:21 PM   #41
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Re: Has anyone talked to their doctor about EMSAM?

Have you ever taken a stimulant before? It seems like you're pretty sensitive.

Did your pdoc consider giving you an actual sleeping med, rather than have you just take Valium? It's probably worth considering.

Do you normally have any symptoms of depression? Do you think this is helping with mood at all?

 
Old 09-04-2006, 06:48 PM   #42
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Re: Has anyone talked to their doctor about EMSAM?

I've never taken a prescription stimulant before. I do know from history that caffeine wires me up. I couldn't take Midol years ago, since it would drive me up a wall(I think it has caffeine in it). Antihistamines in cold meds did the same.
I honestly didn't even know that the Emsam was a stimulant. My pdoc just knew that I couldn't handle the SSRIs, and told me the patch helps with Social Anxiety Disorder. I was (and still am) worried about warnings not to take it if there is history of Mania. I have at least three generations of family members who are Bipolar and my sister needs to take anti-psychotics. - so the genetic predisposition is there, and apparently the EMSAM can trigger it. But my pdoc told me to trust him, since I have no personal history of it myself.
I'm seeing my pdoc tomorrow, and I'll let him know about my hyper state.
I have never been diagnosed as depressed, although I know I have definitely been depressed at times.
The thing is -I can't really tell if my depressed phases were due to situational issues-like relationship breakups or whether my hyper state right now has to do with some very severe social/financial problems that have cropped up recently, which are totally consuming me right now.
My inability to sleep might also have a lot to do with the stressful situations I am now experiencing. I was pacing in my driveway for 2 hours this morning, thinking about some jerk who is intentionally trying to **** me off at work-and he's obviously succeeding.
People have told me at times in the past that I've seemed depressed.
As for sleep aids- I've taken Ambien in the past for insomnia, but it only worked for a few days and then I would become totally dependent on it. (When I would try to get off it after 3 days of it working great, I'd find I couldn't sleep one wink without it.) I do think Ambien is a wonderful sleep aid for the occasional need to get a full night's sleep before some important day but not for on a regular basis. I never woke up groggy from it.
I asked the pdoc for Ambien when I was trying the SSRIs, but he said that I don't need Ambien if I am taking the Valium.
And I don't want to go without the Valium since I feel it helps me. It works immediately (within 10 minutes) for my anxiety. I also take the beta-blocker Inderol on occasion when I need it - an hour before situational anxiety, like when I know I have be assertive with someone who is intimidating, or when I might need to speak in front of a group, or to an authority figure.
I do have a strong feeling the EMSAM patch could help people with depression. I don't feel at all depressed-I actually feel like I'm ready to "take on the world" right now, with all the energy I have now on the patch-but I still have anxiety.

 
Old 09-04-2006, 10:11 PM   #43
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Smile Re: Has anyone talked to their doctor about EMSAM?

it's lulu yes, i am still on Emsam patch - i really don't know what my alternative is at this point but to use it it has greatly relieved my depression for which i am most grateful i continue with the allergic rash and insomnia but still with 6 mg lunesta at 10 pm i'm sleeping from 3-4 a.m. instead of 6-7 a.m. your idea about custom compound to possibly avoid allergic reaction never occurred to me - i'll look into it thanks for the idea i continue looking for the 5 mg oral selegiline and found someone who gets it out of country - i'm not courageous enough to self prescribe i'm trying to find FDA status on approving 5 mg oral for depression

 
Old 09-05-2006, 12:13 AM   #44
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Re: Has anyone talked to their doctor about EMSAM?

Do you suspect that it would help with seasonal depression as well, as major/atypical/depression and dysthymia? I worsen in the winter. I know first line treatment would be light therapy then SSRI's, then SNRI's, but they haven't worked well for me. I think the EMSAM may help during my other periods of depression, so maybe seasonal too. Who knows... it's all a crap-shoot with meds and reactions. I didn't end up getting EMSAM or any AD at my appointment, however, got Provigil, which I greatly needed so I somewhat pleased at the moment. I think my doc didn't want to make more than one change at a time. My next appointment is in 6 weeks. I know my seasonal depression will be starting up then (he doesn't know I have it, I forget to mention things). I'll probably have to address it, even if I ask about Celexa or something that I don't really want, just to bring up the matter. Then may throw in EMSAM. My insomnia is not so bad right now. Tne idea is to use the Provigil to stop me from sleeping 18 horus a day, which I've been doing lately, and get more active. This should help me be tired enough to sleep.

Thanks for the update girls!!

 
Old 09-06-2006, 05:11 AM   #45
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Re: Has anyone talked to their doctor about EMSAM?

That is very interesting, Jealibeanz. My pdoc wanted to put me on an anti-narcoleptic/stimulant med to counteract the 16 hour/day I slept on SSRIs. I wonder if he had Provigil in mind. At the time, I thought it was a crazy idea and I refused to take a med for a condition I would not normally have if I wasn't on those SSRIs. But now I find myself taking the stimulant, EMSAM patch, and continue to have the severe insomnia. I saw my pdoc yesterday and he did acknowledge that EMSAM can cause insomnia, but he believes there is something I can take to counteract it. He's going to get back to me in 2 weeks. For the time being, he advised I take the Valium at bedtime. I took more than 5mg Val. last night and slept for a few hours, but then I was up again half the night and gave up trying to sleep by 5 am. Tonight I will take the full 10 mg.
I have also suffered from seasonal depression. Have you ever tried the light therapy for it? Is it covered by medical insurance? I think I will take a vacation this winter-even if it means for a just weekend somewhere down South.
I also told the pdoc about my hyper state from the EMSAM and he acknowleged that the EMSAM can cause Mania.
We agreed that I should stay on the meds for the time being since it might help my SAD. (Social anxiety disorder). But either way, having to take SSRIs and a stimulant, or taking EMSAM and a sleep enhancer, -both seem unacceptable to me in the long run.
There has to be a better solution!!

 
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