I tried Emsam for a very short time in the past, and am desperate enough that I've been trying it again for the past week. I cut a patch in half and did 3 mg for 2 days, then have done 6 mg for 5 days.

I thought the first day I felt a little bit of positive effect from even the first patch. I'm thinking this was because I've just been depressed and so tired that any increase in energy feels good at first. I'm just really concerned about what it's doing, though, and I know I've gotta wait and see but I'm worried.

The first day I went out after starting the 6 mg, I felt so weird. My vision was off, in a way I can't even put my finger on. I just noticed when I was driving that something was different. I think it's almost like I can't see as much to the sides, and then even my vision straight ahead is a little off, too. I've also had this weird feeling which, even though I've really been struggling with derealization/depersonalization, I think is from the Emsam. It's not even the same as the DP/DR I've felt before, but it's like I just can't get a grap on what is real, or feel like I'm really where I am, if that makes sense. Time has been passing weird, too. The weirdness has continued and today I had to go home early from work partly because of it.

I think it's making my social anxiety worse, too. Everything's just been worse lately for me already and my memory's horrible so it's hard to tell, but I'm pretty sure I'm having more anxiety/paranoia about what other people think about me. I wouldn't expect this, especially so soon, and I'm desperate for it to work so kinda in denial, but I swear it's making me feel less motivation and more apathy. Generally I just feel pretty weird, and there's been some nausea, muscle aches, and bad headaches, too, but those don't worry me quite as much.

It's just one of those things I know I probably don't have much choice but to wait out, but I'm really worried for a few reasons. I started a new job a little over a month ago, and even just holding on and dragging through it this long has been a miracle with my recent mental health, I wouldn't normally be able to do that in the past while badly depressed and such. I'm pretty sure the Emsam has been giving me an extra kind of apathy that's kinda had me feeling like, "well, it's not that important. If I lose the job I won't be surprised," and it's been harder to get out of bed in the mornings. It's also making it even harder to think clearly, whether that's a direct side effect or from the increased anxiety, and it's so hard to function with any decrease in mental functioning right now.

Also, during the winter of 2014, I went from a horrible depression into a psychotic breakdown. I've never had psychosis any other time, and have chalked it up to possibly psychotic depression hugely amplified by meds. Long story short I'd been switching meds like crazy, back and forth quickly between Nardil, Parnate, Emsam, and possibly some others, under horrible psychiatric care. I've always believed it was mainly the Parnate, but I did spend a really short amount of time on Emsam in that spell, too, so I can't help but be nervous about it.

I guess I'm just wondering if anyone can share their experience with Emsam and starting on it. Has anyone had badly increased anxiety with Emsam that went away? Should I stick it out or is it not worth it? Hmmm.


Edit: Forgot to ask, if anyone knows, as far as dosing... I know 9 mg is where it switches from just MAO-B to MAO-B and MAO-A and have read that's also where it switches from just increasing dopamine to increasing serotonin and norepinephrine, too. I've assumed that that means a higher dose would be better because increasing all 3 would be less likely to just cause agitation and stuff and balance things out more. I've also read at least 1 or 2 people saying 9 mg actually caused them less anxiety and activation than 6, because of these reasons. So I've been trying to rush to 9 mg assuming that it'd be worth the rough start and decrease anxiety once I got there, and this wouldn't be a med that could be better at a lower dose for sensitive people. Is this right, or am I wrong? Could it end up being good and possibly useful to stay lower?