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Emsam Patch - Does It Make You Hungry? I'm Starving All The Time!


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#1 JennaJJ

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Posted 04 April 2007 - 04:54 AM

Hi,

I started the Emsam patch a couple weeks ago and the last few days, I have been starving, constantly hungry.

Before I started it, my appetite was pretty normal, but now, all I want to do is eat eat eat :icecream:

Does anyone else have this side effect?

Thanks :)

#2 jealibeanz

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Posted 05 April 2007 - 09:59 AM

I've never taken it, sorry. But I'm hoping you could offer some help.

Have you gained any weight as a result? Is it helping with depression? How about anxiety?

I've gained a lot of weight while taking Paxil, Buspar, Effexor, and Wellbutrin... of all things. They never made me hungry, actually I ate very little and worked out a lot. They just made weight pile on.

I'd like to take something for depression/anxiety. I have a lot of anxiety. I haven't had much luck except for Xanax.

#3 JennaJJ

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Posted 06 April 2007 - 12:05 AM

Have you gained any weight as a result?


No, I haven't gained an ounce. Also, my p-doc didn't say anything about increase/decrease in appetite due to Emsam. My speculation is, that because I have slightly more energy, my body is demanding more "fuel" ... that's just a complete guess.

I haven't had much luck except for Xanax.


I hear you. Xanax was the first thing to ever control my panic attacks and, what I call "anger attacks."

Is it helping with depression? How about anxiety?


It's hard to tell because I'm only on the 6mg now, which is the "starter dosage." On 6mg, Emsam only stimulates 1 enzyme responsible for mood. At the theraputic dose of 9mg, it begins to act on 2 enzymes... and that's when it's supposed to work full throttle. Some people need 12mgs. Anyway, I start the 9mg tomorrow.

Here's what I've noticed so far, the good and the bad.

Cons:

Increased appetite, but again, this may pass or be due to having more energy.

Pros:

I'm using less Xanax.... down by about .5mgs a day.

I'm clear headed and not in a "SSRI fog," which is what I'd felt previously on other meds.

Haven't had any major crying spells. I did get teary twice this week... but hey, I was watching Oprah, so don't know if that counts, lol.

Hasn't effected my sleep - no insomnia or drowsiness.

Not as tired during the day.

------

So overall, I'm not ready to rave about mood and anxiety improvement, but I am impressed that the side effects are practically non-existant. My pdoc said I'd need to be on the 9mg patch for at least 12 weeks to ascertain how effacious it is for me.

Btw, this is the last AD my pdoc is trying with me. If it doesn't work, he's suggesting ECT or VNS.

Edited by JennaJJ, 06 April 2007 - 12:07 AM.


#4 vince1303

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Posted 08 April 2007 - 03:24 PM

Hi, can you tell me something about this patch? I have never heard of it before. I live in Ireland and I don't think it is available here. I have just been prescribed Lexapro for depression and am now in day three of treatment. Finding the side effects quite bad. Would appreciate any advice you might have. Thanks Vincent

#5 KeepingAwake

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Posted 08 April 2007 - 03:27 PM

Hi, can you tell me something about this patch? I have never heard of it before. I live in Ireland and I don't think it is available here. I have just been prescribed Lexapro for depression and am now in day three of treatment. Finding the side effects quite bad. Would appreciate any advice you might have. Thanks Vincent



The EMSAM patch is a MAOI drug. Usually these are used when other types of medications have not worked. They have a lot of interactions with foods and medications and are therefor usually only tried if other medications have failed.

Lexapro is the strongest of the SSRI's, usually shows results quickly and has fewer side effects than many other SSRIs. What dosage of Lexaro are you on and what time of day are you taking it? What types of SE's are you experiencing?

KA
Beliefs Aren't Etched in Stone... Unless Your Brain is Made of Rock

#6 JennaJJ

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Posted 08 April 2007 - 06:22 PM

The EMSAM patch is a MAOI drug. Usually these are used when other types of medications have not worked. They have a lot of interactions with foods and medications and are therefor usually only tried if other medications have failed.


Hi Ka.

That's not true hon.

It's an MAOI-B, which is different than the MAOI. The patch, approved in March 06' is transdermal and does not go through the digestive system, which is why there are no dietary restrictions at the low dose and only minor ones at 9mgs.

I know we can't post links here, but this is from the FDA website:

"At its lowest strength, Emsam can be used without the dietary restrictions that are needed for all oral MAO inhibitors that are approved for treating major depression."

(the title of the article on the FDA site is "FDA Approves Emsam (Selegiline) as First Drug Patch for Depression" )

For the highest doses of Emsam, this is the full list from my product insert of what foods to avoid:

Dried meat
Broad bean pods (fava beans)
Aged cheeese
Tap alcohol
Concentrated yeast extract
Sauerkraut
Soybean products


Lol, and I already don't eat any of those.

Edited by JennaJJ, 08 April 2007 - 06:24 PM.


#7 jealibeanz

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Posted 09 April 2007 - 05:34 PM

It's said to be an MAOI-A at higher levels (9mg and 12mg, possible some MAOI action at 6 mg too, it depends on the individual).

How did you do on SSRI's? What were your side effects (weight gain?) and why did you choose to move on to EMSAM instead of trying all the SSRI's, SNRI's, ect.?

Maybe you have, I just don't know your history.

#8 KeepingAwake

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Posted 09 April 2007 - 05:52 PM

The EMSAM patch is a MAOI drug. Usually these are used when other types of medications have not worked. They have a lot of interactions with foods and medications and are therefor usually only tried if other medications have failed.


Hi Ka.

That's not true hon.

It's an MAOI-B, which is different than the MAOI. The patch, approved in March 06' is transdermal and does not go through the digestive system, which is why there are no dietary restrictions at the low dose and only minor ones at 9mgs.

I know we can't post links here, but this is from the FDA website:

"At its lowest strength, Emsam can be used without the dietary restrictions that are needed for all oral MAO inhibitors that are approved for treating major depression."

(the title of the article on the FDA site is "FDA Approves Emsam (Selegiline) as First Drug Patch for Depression" )

For the highest doses of Emsam, this is the full list from my product insert of what foods to avoid:

Dried meat
Broad bean pods (fava beans)
Aged cheeese
Tap alcohol
Concentrated yeast extract
Sauerkraut
Soybean products


Lol, and I already don't eat any of those.



From the FDA:

The Food and Drug Administration today approved Emsam (selegiline), the first skin (transdermal) patch for use in treating major depression. The once a day patch works by delivering selegiline, a monoamine oxidase inhibitor or MAOI, through the skin and into the bloodstream. At its lowest strength, Emsam can be used without the dietary restrictions that are needed for all oral MAO inhibitors that are approved for treating major depression.

"Emsam provides a significant advance because at least in its lowest dose patients can use the drug without the usual dietary restrictions associated with these types of drugs known as MAO inhibitors, said Dr. Steven Galson, Director for the Center for Drug Evaluation and Research.

Emsam has been shown safe and effective for treatment of major depressive disorder in two 6-8 week studies and also in a longer-term study of patients. The data for EMSAM 6mg/24hr support the recommendation that a modified diet is not required at this dose. Patients are advised to change the patch once a day. The more limited data available for EMSAM 9mg/24hr and 12mg/24hr do not rule out food effects so that patients receiving these higher doses should follow dietary restrictions that advise them to avoid certain foods or beverages. This includes foods and beverages such as aged cheese and alcohol.


Yes, Emsam falls under the general class of MAOI. Whether or not it requires dietary restrictions is dependent upon dosage.

KA
Beliefs Aren't Etched in Stone... Unless Your Brain is Made of Rock

#9 JennaJJ

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Posted 09 April 2007 - 08:06 PM

It's said to be an MAOI-A at higher levels (9mg and 12mg, possible some MAOI action at 6 mg too, it depends on the individual).

How did you do on SSRI's? What were your side effects (weight gain?) and why did you choose to move on to EMSAM instead of trying all the SSRI's, SNRI's, ect.?

Maybe you have, I just don't know your history.


That's right :bump: it's a B (one enzyme) at 6mgs, and A and B (both enzymes) starting at 9mgs. But, I don't know the particular names of the enzymes. :hearts:

I've never responded well to any SSRIs/SSNRIs/Tricyclics, etc. I'm diagnosed with "Refractory Depression" - which is just another way of saying, I don't respond to those classes of medications. I've been on about every antidepressant, starting in 1989, including all the a-typicals. The way my pdoc put it was, although the medication is in my system, my brain doesn't release it correctly. In some cases, when this happens to someone and they've tried everything, they can have ECT (electro convulsive therapy) and it will "reset" the brain to release the SSRI theraputically.

I was scheduled for ECT a month ago, but didn't follow through. I knew there was only 1 class of AD's I hadn't taken yet (MAOIs), so we talked about it. Hence, the Emsam. I would have taken MAOIs sooner, years ago, but the dietary restrictions were so strict, that it worried me. So, when the patch came out, it was finally on the table to consider. I'm reeeeally hoping that it works and I'm trying to stay really positive.

#10 jealibeanz

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Posted 23 April 2007 - 06:00 PM

Jenna-

How are you doing? Are you still taking EMSAM? Have you noticed any improvement or side effects? Let us know how it's going. :)

#11 jealibeanz

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Posted 15 May 2007 - 05:01 AM

Hey Jenna are you still here?

#12 eve123

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Posted 15 May 2007 - 02:13 PM

Jenna;

I am hoping that the reason you are not hanging around here much is b/c you are feeling great and the Ensam really is working for you! After a long period of Depression there's aot of life to catch up on I'm sure!

Or, perhaps you have been too down to post, (that happen's to me)? Please know that we care about you and want to hear from you!

Wishing you the best! eve

#13 Aron

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Posted 21 May 2007 - 10:16 PM

It's been a while since I been on it but I don't remember getting hungry on it.
"I am the way, and the truth, and the life; no one comes to the Father but through Me."

#14 eve123

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Posted 23 May 2007 - 09:33 PM

It's been a while since I been on it but I don't remember getting hungry on it.


Hello Aron;

May I ask why you stopped taking it? I remembr reading it awhile back but it would be helpful if you hve time and would tell me what you think about Ensam from your experience.

BTW...I hve read that two people mentioned excess hunger so far. As far as weight gain...that remains to be seen, I guess.

eve

#15 Aron

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Posted 24 May 2007 - 08:40 PM

I stopped taking it because like most other meds I did not get much benifit from it. Also the patches got annoying for me.

It's been a while since I been on it but I don't remember getting hungry on it.


Hello Aron;

May I ask why you stopped taking it? I remembr reading it awhile back but it would be helpful if you hve time and would tell me what you think about Ensam from your experience.

BTW...I hve read that two people mentioned excess hunger so far. As far as weight gain...that remains to be seen, I guess.

eve


"I am the way, and the truth, and the life; no one comes to the Father but through Me."

#16 mimsy

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Posted 18 February 2008 - 08:25 PM

I had weight gain on EMSAM. I was on the 6 mg patch for 2 months, then went to the 12 mg and was on that for about 5 months. I must have gained 5-10 pounds (I don't have a scale so I can't say exactly, but none of my clothes fit and I mean I had rolls of fat that I'd never had before; very different experience for me and didn't seem like my metabolism at all). When I would bring it up, my psychiatrist kept saying no, no, if anything, EMSAM makes you LOSE weight. And that is what the drug co says too, but if you look at the actual data from trials, a small percentage of people did gain weight but a slightly larger (but still small) percentage lost weight, so they just go ahead and make the claim that "overall, it causes weight loss in some people, not weight gain."

That wasn't the primary reason I stopped the drug, but it was like I knew I was packing on the pounds and just wasn't that concerned about it. However, it was worrisome b/c I felt like I SHOULD be concerned about it. For one thing, I can't afford to buy a whole new set of clothes! For another thing, it's not good for my health and I've always been a thin person, so it didn't seem natural that I didn't care at all.

There were other things similar to this feeling of not caring. For example, the primary benefit that I got from this drug was decreased social anxiety and increased social/self confidence -- however, this meant that I was apathetic towards things that maybe I SHOULD have cared about. One of my big problems is inability to sleep/wake on a schedule, sleeping through alarms and missing work -- so although EMSAM made me feel better, it also made me more apathetic - I didn't get as depressed about missing work - and I mean I felt more confident, but that meant that I felt fine about getting up late and going to work with no shower, for example, or wearing dirty clothes, or, like I said, putting on weight. And my attendance at work didn't improve; I just felt less bad about missing the work or being late; that's not too motivating really. That's why I decided to stop the drug. It did help the depression for me, but it didn't help w/ my sleep problems and resulting work problems.

I lost weight within the first WEEK of dropping back down to the 6 mg patch. I did not make a conscious effort to do this. So I do think some people DO have increased appetite/weight gain on this drug, and maybe the product literature underestimates this (maybe they got a skewed sample, who knows?). Obviously it is to their benefit to present data in such a way (without actually lying) to minimize this side effect, since not many people are going to want to take a drug that will make them put on weight. And I'm sure that probably less people will put on weight if they don't think it's possible/likely due to placebo effect.

I would give the drug a chance to work before going off of it so soon; maybe your hunger will subside and you won't gain significant weight, but just wanted to share that I had weight gain that didn't appear to be slowing down, regardless of what the med label or my psychiatrist say SHOULD have happened.

Hope this helps at least relieve any thoughts you might be having that you're the only one, or if your doc or the med pamphlets seem to suggest that what you're experiencing isn't real. Get a scale and keep a log if you're worried that it's in your head. Bring the log to the doc if s/he doesn't believe you. Good luck.




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