![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by UgottaHaveHope on February 18, 2007, at 15:11:30
I know this story sounds twisted, so let me start from the beginning: I had agreed to try Emsam for 8 weeks and then my pdoc said he would let me try Nardil, which seems to address Generalized Anxiety Disorder a little better according to a lot of people and a lot better according to Ace the Champ. I have been doing a lot of research on Nardil and was building up my confidence to take it.
Life on Emsam the first five weeks was bearable (4-5 on scale of 1-10). However, all of sudden, something this week (week #5) has kicked it. I am feeling better, like a 6 or 6.5. Now some of it could have to do with the fact I am taking Klonopin 3mg per day, rather than just as needed. I am also taking 150 mg of Seroquel, which also hits the anxiety and makes me quite groggy (but well worth the trade-off).
Here is something also interesting: Because Emsam was giving me a little extra energy boost each day, which is what it is designed to do, I started actually (by accident) to put on a new patch right after I brushed my teeth for bed. This has appeared to make such a big difference.
You know how they say Emsam puts a consistent level of meds into our body 24/7? Well, I may be wrong, but I feel like it puts it as its strongest level during the first 8-10 hours of the patch. So my theory is when I put the patch on just before bed, it is dueling it out with the Seroquel, which in turn gives me less anxiety during the day.
I am still faced with this question: If you were feeling like a 5-6.5 on Emsam, would you go ahead and try Nardil if there's a chance that it could make you feel even better? There is no washout period between the two, and I could give Nardil a two-month trial and then go straight back to Emsam if Nardil does not perform well.
What would you do?
Posted by Phillipa on February 18, 2007, at 15:16:31
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
Michael this is truly exciting. I don't know what I would do. I think let the doc know first. Wow. Love Phillipa
Posted by Quintal on February 18, 2007, at 16:57:07
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
If you're treatment resistant I'd stick with the EMSAM. It can be hard to find a med that works well and it could well be a mistake to ditch EMSAM and try Nardil and find it doesn't work or you can't tolerate the side effects, only to return the EMSAM and find it no longer works. I think there's too much experimentation by people on these boards - and I wasted years of my life doing it myself, thinking for example, the Effexor people might be having a better time when I was on Zoloft. Then ooh, maybe the MAOI people are better off than the Effexor tribe, so I switch to Marplan...............and on and on.
So long as you're doing well with a treatment this is the best you can reasonably expect. I think there's some truth in the adage 'The grass is always greener on the other side' here. Otherwise it might start to look as though you're looking for drug-induced euphoria not just wellness.
Good luck with the EMSAM. I hope it continues to get better and better.
Q
Posted by UgottaHaveHope on February 18, 2007, at 18:10:40
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
I think Quintal makes an excellent point when he says if I am doing better on the Emsam now, and I do two-month trial on Nardil, then have go back to the Emsam, then the Emsam might not work like it is now?
IS IT WORTH THE RISK? I mean, what if I feel better on Nardil? Have you ever gone back to a med and not have it feel as good as it was the first time?
Posted by chiron on February 18, 2007, at 18:25:13
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
That is so good to hear. Tonight I am going to apply my first Emsam patch.
I wasn't sure if morning or nighttime would be better. Have you tried taking it in the morning?
When did you begin taking Klonopin regularly?
Posted by Crazy Horse on February 18, 2007, at 19:41:55
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
Stick with the EMSAM Michael, just because Nardil works so well for 'ace' is no guarantee it'll do the same for you...it's possible it will not work at all. Be happy EMSAM is kickin' in for you! :)
-Monte
Posted by notfred on February 18, 2007, at 20:34:07
In reply to What would you do? SLS, Larry, Yxibow, Blueberry?, posted by UgottaHaveHope on February 18, 2007, at 18:10:40
You are **only** 5 weeks on this AD and it is starting the work. Listen to Quintal.
Posted by laima on February 18, 2007, at 21:42:55
In reply to Re: What would you do? SLS, Larry, Yxibow, Blueber, posted by notfred on February 18, 2007, at 20:34:07
I agree- rejoice that the Emsam 6 patches are starting to work, avoid switching at this time. If you continue to feel only modest improvement, why not talk to your doctor about the dose?
Posted by Honore on February 18, 2007, at 22:34:44
In reply to Re: What would you do? SLS, Larry, Yxibow, Blueber, posted by laima on February 18, 2007, at 21:42:55
Yup, listen to Quintal.
You can always try Nardil later. See how far Emsam goes for you.
Honore
Posted by Larry Hoover on February 19, 2007, at 6:38:14
In reply to What would you do? SLS, Larry, Yxibow, Blueberry?, posted by UgottaHaveHope on February 18, 2007, at 18:10:40
> I think Quintal makes an excellent point when he says if I am doing better on the Emsam now, and I do two-month trial on Nardil, then have go back to the Emsam, then the Emsam might not work like it is now?
>
> IS IT WORTH THE RISK? I mean, what if I feel better on Nardil? Have you ever gone back to a med and not have it feel as good as it was the first time?There is no need to abandon a treatment with promise. Period. Your plan to switch to Nardil can simply be postponed. You can do Nardil whenever. At some future time, if needed.
Let the Emsam do its thing. Consider dose increases, if reasonable. Etc. Don't look a gift horse in the mouth.
Lar
Posted by lcat10 on February 19, 2007, at 22:06:00
In reply to Oh no, Emsam (6mg) may be working ..., posted by UgottaHaveHope on February 18, 2007, at 15:11:30
My pdoc said it sometimes takes 5-8 weeks with some people for Emsam to work. What about trying the 9 mg. patch if things don't improve?
Unfortunately, I was on the 6 mg. patch, then the 9 mg. patch, and now the 12 mg. patch for the past three to four weeks, and I am still severely depressed. So, it did not work for me. I had a two day period when it looked like it might work as I started to feel some better, like maybe a 3 or 4, but then I was back in the pits right away.
Posted by UgottaHaveHope on February 19, 2007, at 23:21:37
In reply to Re: Oh no, Emsam (6mg) may be working ... » UgottaHaveHope, posted by lcat10 on February 19, 2007, at 22:06:00
I have anxiety-induced depression, or generalized anxiety disorder. When I get at my worst with anxiety, thats when I get depressed. That's why I am taking a hard look at Nardil, which is supposed to be better for anxiety.
Posted by psychobot5000 on February 20, 2007, at 18:41:23
In reply to Re: Actually I want less stimulation » lcat10, posted by UgottaHaveHope on February 19, 2007, at 23:21:37
I agree with everyone! If EMSAM's working, why not stick with it! ...Nardil might give you the same benefit, but with far stronger side-effects. It's so hard to find something that works!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.