I've been on Emsam for 7 years. When I was first on it I had anxiety and needed extra meds to slow things down some because I was agitated. That lasted a few weeks and then I went to 9 mg and things settled. I never considered whether 9 was better because of the way the med works; I just assumed it was the dose I needed and didn't think about it. I never really had any of the distress you've been experiencing that I remember. I started it IP and I know the first few weeks back to work were hard but I remember that as lingering depression and anxiety.

I have been on lower doses at times when I have been manic and needed less stimulation and the lower doses did help calm me down.

The anxiety at first did go away and I got off the meds I needed for anxiety the first few weeks. I was feeling pretty good on it by a month on 9 mg (2 months total).

I like it. It really has no side effects for me unless I'm manic and then we just cut the dose. It works well and has been the only AD that has done this for me.

If I can answer anything else let me know. I'm not sure I answered what you were asking very well.