I think Emsam takes about 4 days to stabilize although I increased it last week and felt it almost immediately. Honestly I understand why your pnurse is concerned but it is normal to get agitated/hypo at first on it and then after your body is used to it you can tolerate more. I struggled to tolerate 6 mg at first but AD-wise needed 9 so went to 9 and used a lot of meds to calm me down for a month or so and then I was fine with just 9. Now I'm on 12 and am not agitated at all (but I think I was more depressed than I knew).

Alcohol definitely doesn't help. It is a depressant and well, I don't know what else to say b/c I have no experience with it. It doesn't play well with Emsam although you're still in the safe zone there.

I hope you start feeling better soon.