I'm interested in this medication. It's a transdermal (patch) MAOI (selegiline, a very old Alzheimer's medication), released this winter for depression. I haven't had much luck with SSRI/SNRI's. Has anyone talked to their primary care doctor or psychiatrist about this drug? I'm wondering what they think of it so far.
Re: Has anyone talked to their doctor about EMSAM?
Hello.....no I haven't heard of this....but am doing the alternative...SAMe.......hope you find that this helps you....I'm wondering though....I have used the pain patches....and there were times they fell off....think I would be concerned about that with this type of patch.......just a thought.....are you using it yet?? ..........
Re: Has anyone talked to their doctor about EMSAM?
Hi jealibeanz,
The problem with MAOIs is that they require the patient to stay away from certain foods, and there's a lot of them. Without sticking to the diet though you can cause your blood pressure to rise, seizures or even death.
The good news about MAOIs is that they are known to be very effective on people who have a treatment resistant condition. So if that's you they maybe worth considering.
My psych wanted me to try MAOIs before, but when I explained that oft times when I'm feeling suicidal I wish I was already taking them so I could binge on the foods I'm not allowed we decided it wasn't a good idea. That's a decision you need to make. The good news is that from what I understand the lower strength patches don't require any dietary changes.
There was a thread a month or so ago called '[whatever] transdermal patches'. Nobody here had anything to say about them then either. At the end though I posted a link to a long thread on another forum. I don't know if the link is still there as I shouldn't have posted it, it should have been an instant ban (stupidly I hadn't read the rules then). You might want to look for it though.
Re: Has anyone talked to their doctor about EMSAM?
Many of the foods once restricted are no longer a problem due modern day processing. There are actually no foods that I would ever eat that are restricted, absolutely none. Cheese is commonly considered dangerous, however, the types I would eat are not restricted, but I haven't eaten cheese in years anyway. Tap beer is also restricted, but if I ever do have the occasional beer, it is always from a bottle or can. I hate drinking tap. I don't eat pickled meats. I am in very good shape and don't have hypertension.
Re: Has anyone talked to their doctor about EMSAM?
What kind did you doctor want you to try? I'd like to, but am unsure if my primary care physican would suggest it (probably not). I'm in the U.S. so you aren't familiar with our type of practice.
Re: Has anyone talked to their doctor about EMSAM?
Well that's good if you don't eat any of those foods. I was given a list of the foods categorised into low, medium and high risk. I eat just about every food on that list and it would mean big changes to my diet. What's more alot of them are also what I'd eat on a happiness-binge when I'm feeling low, so the risk is just too high. But if it doesn't affect you very much, then that really is great.
Yeah our system is very different from your own. Personally (and I think this is typical in the UK) I have a GP and a psychiatrist. The GP is just like your family doctor. The GP initially refers a patient to the psychiatrist. The psychiatrist then talks to the patient and decides what meds are needed, which the GP then prescribes. I very rarely get to see the GP, every few months or so as he likes to see how I'm getting on. It's my psychiatrist which likes the MAOI for those with a treatment resistant condition, according to my GP he raves about them.
I hope that answers your question, if not just let me know. Are you treatment resistant by the way? If so perhaps it would help to take some research on MAOIs with treatment resistant conditions to your primary care pyhsician.
Re: Has anyone talked to their doctor about EMSAM?
Well I'd do some research then and get some statistics. I'm the same as you, loads of side-affects but no benefits at all. The meds I'm on at the moment are the last available to me and there's no benefit again. My next hope is surgery.
Re: Has anyone talked to their doctor about EMSAM?
Well I don't feel I'm anywhere near the option of surgery, I just need to get someone to be willing to work with me and let me try more than just SSRI/SNRI's. It seems like even specialists here are becoming more and more reluctant to prescribe anything other them.
Re: Has anyone talked to their doctor about EMSAM?
I just got prescribed this yesterday and got samples. I've tried practically everything else with no luck, particularly for anxiety not depression. Even though they claim there are no interactions at the low dose I am prescribed (6 mg), I am 20 years old and in college, I don't want to base my life around a patch.
Re: Has anyone talked to their doctor about EMSAM?
Who prescribed it? A general practitioner or a psychiatrist? What else have you tried and how long have you been trying to treat this? What kinds or responses and side efects have you had in the past? Did you suggest the patch or did your doctor? Yeah, I admit putting the patch on may be a little annoying, however, if it works, I'm sure it's worth the hassle. Let me know how it goes.
Last edited by jealibeanz; 07-14-2006 at 06:11 AM.
Reason: more comments
Re: Has anyone talked to their doctor about EMSAM?
How many years have you been in treatment? You definitely have tried more medications than I. I only see my family doctor and haven't had any luck with pdoc's or other doctors. I like my practitioner. He's very nice, friednly, and caring. I just hope he can give me the treatment I need. I don't know if he'd consider this, or or any other med than an SSRI. Did your doctor mention possible side effects? Insomnia, apathy, weight gain? I won't tolerate any!!!
Re: Has anyone talked to their doctor about EMSAM?
I'm always surprised when some doctors are willing to keep trying to treat depression for years without major success, while others give up after a few failed trials. I've read so many mixed reviews about EMSAM, I don't know what to think, but I feel I'm a good candidate. I have treatment resisrent, atypical depression, along with anxiety.
Re: Has anyone talked to their doctor about EMSAM?
i've been on it for two weeks with good results. not yet great, but good results. i am on a high dose. as for the dietary restrictions, with the lower therapeutic dose of the patch, none are required. additionally, the diet list was modified down several years ago for maoi's, and some have no problems with any of the foods. i am one of those. but the restrictions are not to be taken lightly until you have become familiar with whaat you can handle.
selegiline (0rally) has been around for years and used to treat parkinson's. years ago, when i first learned about the selegiline patch starting clinical trials for depression, i got my cutting-edge p-doc to prescribe the oral pills for me and for the first time in several years i was depression free and a new, active, confident person. after about 1 3/4 years, while under the stress of divorce, the meds stopped working. since then, (5 years ago) i have had severe depression. the new patch, after being off the oral pills for a while, appears to be helping again. for me, selegiline has been the best drug i've ever found. i hope i return again to comfortable mental functioning. i am optimistic. Note: the MAOI's work especially well on "ayptical depressions." check with your docs to see if it might good for you. good luck to us both.
please forgive typo's and errors. am using a new laptop and am not quite used to it's pecularities.>smile<
Re: Has anyone talked to their doctor about EMSAM?
Good to hear... What dose are you taking? What have you tried in the past? Does you doctor have a favorable opinion about EMSAM? I'm wondering if it has any sort of reputation yet within the medical community, positive or negative. I hope my doctor has at least heard of it! I have, so he should too, right?
Re: Has anyone talked to their doctor about EMSAM?
i'm on 30 mg. patch per day. i've tried virtually all the newer ssri's and ssri-like clones as well as many of the old trycyclics. i've been fighting depression for two decades, before the ssri's came out. my best results have been with the maoi's. parnate worked for me for years but eventually fizzled out, altho i have remained on it because it still helps abit. the only way i know it helps is that i feel so much worse when i come off it; yet back on it i'm still depressed, but the subjective degree of the depression is clearly better. i am using both the emsam and the parnate (most doctors won't combine maoi's, but i've shown thru the years that i do well on the combo and i have no blood pressure problems (i check it regularly). as for emsam's reputation to date, i don't know...it's so new. in fact, that's why i came to the boards to see what others are saying about it. i suspect because it's an maoi a lot of people will choose to stay away from it, which is a shame because the maoi's have traditionally been considered the best antidepressant category in terms of efficacy, but the risks have scared both doctors and patients away. i suspect there will be a lot more interest in them now and more people will educate themselves about maoi's and a dialogue will begin with patients and doctors. selegiline (emsam) is what's called an maoi-b (parnate and the others used previously for depression are maoi-a's). the "b" variety does not carry the same risk factors as the "a's" when kept in the lower therapeutic ranges. i'm, too, interested in how well this drug is received and how successful it is. also, as stated before, the atypical depressions (which i have) have always responded best to maoi's.
i hope this thread keeps on keeping on and i can learn more about the success of this new depression drug with the novel delivery system.
Re: Has anyone talked to their doctor about EMSAM?
When you say 30mg, what level patch is that? I know they come in 6, 9, and 12 mg. Did your doctor suggest EMSAM to you, or did you do research and present it to him?
Of course I can't expect doctors to have much of a solid opinion on the drug, since this formulation is so new. It takes years to uncover the true risks/benefits with patients. Would you think that doctors are aware of the fact that this drug has been released? They may not keep up with every new FDA approval, but this was covered by the news media, so it's a little more high profile than average I'd think.
I'd have no problem adhering to super-strict guidelines so I could try a medication, however, your right, the dietary restrictions are bad. I'm capable of monitoring my BP.
Have you noticed any problems sleeping or an increase in anxiety? Do you take anything else beside Parnate and EMSAM? Has Parnate caused weight gain for you?
Sorry about all the questions! I'd love to hear more success about the medication. I'd really like to bring it up with my doc, but am not quite that confident and don't want to sound like a know it all. Are TCA's the next line of treatment after SSRIs? I know I don't want a TCA.
Re: Has anyone talked to their doctor about EMSAM?
Quote:
Originally Posted by jealibeanz
When you say 30mg, what level patch is that? I know they come in 6, 9, and 12 mg. Did your doctor suggest EMSAM to you, or did you do research and present it to him?
i'm in the united states and it comes in a 30 mg. patch as well as lower dosages.
Of course I can't expect doctors to have much of a solid opinion on the drug, since this formulation is so new. It takes years to uncover the true risks/benefits with patients. Would you think that doctors are aware of the fact that this drug has been released? They may not keep up with every new FDA approval, but this was covered by the news media, so it's a little more high profile than average I'd think.
the infamous drug reps keep psychiatrists informed of ALL new psychotropic drugs in this country. also, this drug has been in clinical trials for years and psychiatrists (many) have known about it. i asked for it when i realized it had finally been approved and my doctor was already considering it for me since i had had good results from the oral form several years ago. it was given to me as an "off label" drug back then but it worked wonders.
I'd have no problem adhering to super-strict guidelines so I could try a medication, however, your right, the dietary restrictions are bad. I'm capable of monitoring my BP.
Have you noticed any problems sleeping or an increase in anxiety? Do you take anything else beside Parnate and EMSAM? Has Parnate caused weight gain for you?
parnate actually has some antianxiety effects, especially for social phobia. it does have to be taken early or it can cause some insomnia, at least that was my experience. it did cause slow weight gain and especially severe cravings for chocolate, but over time that diminished. since starting the high dose of emsam, my appetite has increased a little but when i first started the oral selegiline in lower doses it did not. my doctor thinks that the drug may not have "increased" my appetite so much as it has brought it back to normal. my husband agrees, since i had over the last few months had little appetite at all even on the parnate. i'm not so sure. either way, i don't like the increase but so far it's not severe. currently i take nothing else for depression, altho thru the years i have tried all the combinations suggested for treatment resistant depression with no success.
Sorry about all the questions! I'd love to hear more success about the medication. I'd really like to bring it up with my doc, but am not quite that confident and don't want to sound like a know it all. Are TCA's the next line of treatment after SSRIs? I know I don't want a TCA.
i think there are so many ssri's & ssri-like drugs now that usually the docs will try all those before going to the old tricyclics. tricyclics have a lot of side effects that make patients want to stop them, like sluggishness, excessive dry mouth, weight gain, etc. but, some of the tca's are good, they've just fallen out of popular use because of the lower side effect rates in the ssri's. still, many autorities still believe the best category of antidepressants is the maoi's. theyare just not popular. personally, i recommend them with appropriate patient education and caution.
i do believe in this day and age we have to be our own advocates and ask all the questions we want to understand. most psychiatrists would probably be glad to have an interested and informed patient. i have a full open dialogue with mine and am a participant in my treatment plans. i have, fortunately, a very avant guard doctor. since i have been treatment resistant for so long she appreciates any new ideas i discover thru reading up on current research. i have found some approaches before my doctors did because i am always searching.
(stupidly I hadn't read the rules then). You might want to look for it though.
