Emsam experience vs other MAOI's

[Allieb]

Has anyone has experienced weight gain with Emsam, at about 6-9 mg? I've been on antidepressants since I was about 12 (am now 45) and have taken essentially everything under the sun with mixed results.  I'm interested now in trying the Emsam patch, but I am terrified of gaining weight. I gained a lot on both Nardil and Parnate, so I am leery any MAOI that claims to be "weight neutral".

Water retention is a concern as well...I'm hoping that given that it's a patch and enters directly into the bloodstream, chances of water retention or an effect on glucose or metabolism might be lower.

Does anyone have experiences to share? Any insight would be appreciated!

Edited November 28, 2017 by Allieb

[mikl_pls]

18 hours ago, Allieb said:

Has anyone has experienced weight gain with Emsam, at about 6-9 mg? I've been on antidepressants since I was about 12 (am now 45) and have taken essentially everything under the sun with mixed results.  I'm interested now in trying the Emsam patch, but I am terrified of gaining weight. I gained a lot on both Nardil and Parnate, so I am leery any MAOI that claims to be "weight neutral".

Water retention is a concern as well...I'm hoping that given that it's a patch and enters directly into the bloodstream, chances of water retention or an effect on glucose or metabolism might be lower.

Does anyone have experiences to share? Any insight would be appreciated!

Emsam was weight neutral for me, and perhaps even promoted weight loss for me. That was just my experience. Your mileage may vary (YMMV). It just didn't work was the only problem. I experimented with 12 mg and even 15 mg and only at 15 mg did I start to get a response. So who knows what dose I would've needed? 18 mg? It has been prescribed up to 24 mg I've heard (12 mg x 2). But I digress. I personally didn't gain weight, but I have heard of some who have, but it's not common from what I've read/heard.

If you are looking to give Emsam a try, I'd say go for it! It's a very innocuous medication. 6 mg isn't really effective for most people, I'll just go ahead and say that, and my pdoc said that there isn't much difference in 6 mg and 9 mg, but she refused to prescribe me 12 mg (go figure?).

[BrianOCD]

Hey I have a question about serotonin receptors, and I know you're the guy to ask...

I'm going back up on Effexor XR since it worked so well for me.

I've been up and down on Effexor all year, and when I took the increase dosage it felt like it started working instantly for me, today I feel a lot calmer and a lot less chatter in my head... like I didn't have to wait months or whatever, does that possible?  

[mikl_pls]

9 hours ago, BrianOCD said:

Hey I have a question about serotonin receptors, and I know you're the guy to ask...

I'm going back up on Effexor XR since it worked so well for me.

I've been up and down on Effexor all year, and when I took the increase dosage it felt like it started working instantly for me, today I feel a lot calmer and a lot less chatter in my head... like I didn't have to wait months or whatever, does that possible?  

With Effexor, you have two mechanisms of action, SRI and NRI. The SRI will affect all serotonin receptors, but the main serotonin receptors I believe affecting mood will be 5-HT1A, 5-HT2A, and 5-HT2C. Basically speaking, increased numbers of these receptors cause anxiety and depression, and increased serotonin levels will downregulate or cause them to decrease in number.

With the NRI, I believe I read (in a Google book preview, so no link available) that increased norepinephrine will cause noradrenergic receptors to decrease firing rates but not downregulate.

So at 75 mg, Effexor's serotonin reuptake inhibition is pretty much maxed out--112.5 mg will not yield more SRI. But at 150 mg, you start to tap into the dual mechanism SNRI of the med, and the NRI starts to act, acting on adrenergic receptors.

That's my theory anyway.

But not to deviate from OP's topic.