Emsam (selegiline) Side Effects, Uses Dosages
Side Effects for Emsam (selegiline)
Initially only dry mouth and minor insomnia. Later skin reaction from the patiches.
I started taking in January 2024 (see my post for details.) I responded very quickly and was very pleased. It helped more with anxiety and obsessive thinking than mood elevation but mood was good. The main problem I had with it was the cost - it runs about $2000/month. My insurance covered all but $75 but I have ethical problems with something costing that much that is way past patent. Anyway my experience overall was good. I sweat profusely so once summer weather arrived things started to happen. First it took longer and longer for my skin to heal. The blotches from the patch usually took a few days to disappear and now they were taking longer and longer even with hydrocortison creme. My upper arms, chest, and thighs are now covered with blotches. Then, as he humidity increased, the patches would fall off after a few hours no matter how completely I clean the site before applying. Told my shrink and decided to discontinue. He said because I was on the lowest dose there was no need to taper. Have been off a week and feeling okay. Hopefully this got my thru a difficult time. From my history MAOI's work the best for me.
I'm no longer taking this medication.
I stopped this when the side effects just became intolerable. It was just too hard feeling physically ill all of the time.
History of atypical depression
So far just falling asleep. Benadryl helped.
Perhaps this is a bit premature, but on my 4th day I am feeling terrific. The first antidepressant I took was Nardil 30 years ago. That worked liked a dream but had to stop because of severe insomnia, Like most people on this thread, I have tried almost every antidepressant that was available before 2010. None alleviated my depression as well as Nardil. I "winged it" for the next 14 years. Retirement, Covid, and some serious health problems set me back and I found myself unable to get out of bed and could not complete the simplest of tasks. Causing problems with my spouse. Because of my experience with Nardil I requested Emsam. I was surprised my HMO approved it. Like Nardil, I started feeling good within 3 days. This is my 4th and I am up, dressed, and ready to go! My only complaint is the cost. Fortunately my insurance covers all but $75 but the retail is almost $2000/month - so this is out of reach for many people. Well off patent time and needs a generic.
Insomnia responded to low dose quetiapene. Application Site Reaction responded to using skin lotion to remove.
Life-saving and incredibly transformative medication. Too bad it took me 35 years to get on an MAOI. Psychiatry should be embarrassed that they don't use MAOIs frequently enough.
Increased energy and difficulty with sleep
I've tried a lot of antidepressants over the years for depression and anxiety. The only one i liked was mirtazapine but it caused massive weight gain. Emsam has been great, very limited side effects just stimulation.Sometimes skin pain where i put on the patch but i just move the next one to another spot. 6mg is low dose so i don't need to watch my diet but doesn't work as well as a higher dose.
I started experiencing depressive bouts in my late teens...40 years of therapy, every known medication but few with efficacy. An insightful physician and friend recognized my chronic depressive pain and arranged an evaluation at the Mayo Clinic. They prescribed Emsam and it was like a switch...like going from black and white tv to color. The effects were immediate and have been consistent for over 10 years. It’s a miracle medication for those that have struggled.My only complaint is it’s cost...about $2000 a month. With Medicare its about $700. At times I am unable to afford the prescription and within 2 weeks I return to a deep sorrow, complete lack of mental clarity, frustration and anger... But quickly recover once I’m back on “the patch”. Highly recommended .
Major Depressive Disorder w/BPD
Treatment Resistant Depression
Nausea, constipation, abdominal pain, application site reaction (used nasal spray for allergies on skin before applying to help with this), insomnia (took off before bedtime), agitation initially
I was optimistic about Emsam. Out of everything I've tried in 15 years, Wellbutrin worked the best. It didn't help me enough but it helped with addiction and leveled out my mood. Emsam tops Wellbutrin easily. It feels more natural in comparison, and my abdominal issues are less intense. Unfortunately, Emsam although helps, is not helping enough for me. I've had no issues with the diet. I'd definitely recommend this as an introduction to an MAOI, especially if nothing else has worked. I think I'm on the right track. I'm going to try Parnate next.
Some trouble getting the patches to stay on
I have to say that I have been really impressed with this medication. I have had no side effects and one I figured out were the patches would stick I was good to go. For me this has been the best antidepressant in 20 years.
Insomnia, increased anxiety, panic attacks, hypomania at night, increased depression. I have never been diagnosed with Bipolar I or II but there were definite "bipolar lite"? mood differences.
This site won't let me enter more specific details of my time length and dosage of EMSAM. I was on it for 18 months, not 2 years.This medication worked for a glorious 2 months and then I crashed in a spectacular way. This. drug. is. activating. I spent the first 6 weeks at 6 mg, 6 weeks at 9, 1 month at 12, 9 months on 9, & 6 mg for the final 5 months. The cessations of the 12 mg patch followed by the 2nd try at the 9 mg patch were only done because I got harsh with my psychiatrist and said it was becoming a quality of life issue. The insomnia was unbearable at these levels which created a dependence on Xanax XR. I found a new psychiatrist on 3/1/17 and we completely stopped the EMSAM. I had a VERY hard time coming off this medication, even though I was at the lowest dose. it took a good month for it to leave my body rather than the "normal" 2 week washout. Tried the lowest dose of Cymbalta on days 15 and 18 of the washout and I had dry heaves, extreme nausea, vertigo and feeling faint. I noticed the drug really didn't leave my system until Day 26 or 27 because that's when my current dosage of Xanax XR really began to feel sedating.If we got to try it all over again, my psychiatrist said he may have told me to cut the 6 mg patch in half (which you're not supposed to do) but what's done is done. Btw, the major withdrawal symptom I had was nausea/loss of appetite which began around Day 8 and stayed for about 2 weeks. Now I'm just flat out exhausted. (I'm
Occasional dizziness when standing quickly or urinating while standing
Wonderfully effective, without any mental side effects. It just works, period.
Major Depression and Severe Anxiety
Major insomnia and Severe diahrria. Stomach cramps.
I liked the way it made me feel. But not sleeping and diahrria is just too much.
Headaches (which went away after 10 days) Severe insomnia which I'm still dealing with.
After taking a tricyclic for 25 years (Imipramine) I felt it stopped working as well and I tired of the side effects. Tapering off to try Emsam was hell, and once I was able to start the patch, it did not start working immediately. I noticed a slight difference after 2 days, slightly better improvement after 1 week, and more improvement after a month. The problem is once it kicked in, I developed severe insomnia. I'm on Restoril for sleep right now which is pretty powerful and makes me feel groggy all day. My sleep is still not great and I can often be exhausted. I also need to take my patch off two hours before bed in order to sleep at all even with the Restoril. I'm praying this side effect goes away since I like the patch. It suppresses my appetite and I've lost a few pounds, I do not crave sweets anymore, I have stopped obsessively shopping which used to be a major problem. I have no more constipation- regular bowel movements. It has helped with my depression and anxiety quite a bit- not perfect, but I feel good. I have no issue with redness from the patch itself and I have pretty sensitive skin. Has anyone else had the insomnia and it went away? Would appreciate feedback.
insomnia is beginning to make it impossible to continue at this dosage. I don't think 6 mg will do it: but I'll try. I can't use trazadone because it causes seizures, I take 8 mg Klonopin. and 100 mg of Atarax.. Parnate didn't give me same problem. at 50 mg; just not as effective, The washout period will be hell.
Insomnia, irritability, fatigue, "myoclonic jerks," "visions/hallucinations in side vision, dry mouth, balance issues etc.
I feel a little dumb, in that I only just have realized most of the above are side effects of Emsam. I thought most were due to untreated depression. I even went to an ophthalmologistfor the visions--I now know I also have cataracts--tho' the doc said the visions were due to that. 3 yrs. ago, I had horrible pain and almost every symptopm of depression you can think of. The pain was physical. I got 6 mos of IV ketamine treatments which took the edge off the pain. Then the Emsam plus Ativan for sleep. It probably helped some along w/ the ketamine--but there's been no further improvement. I am going back to Pristiq which is helpful to me unless the depression is very severe. Or I might try Viibyrd.
This is the most effective antidepressant I've ever tried. I was very suicidal and the minute I put on the patch I felt better. I have energy, less emotional and less depressed. It's expensive but any antidepressant that will help me lose weight is worth it to me. It also doesn't make you fatigued like other drugs. At 6mg I can eat and drink whatever I want but on 9 mg you have to cut back on caffeine and other foods that interfere with MAOI's.So glad my Dr. recommended this!
After more than three years, I have had no side effects.
I had tried every Anti-Depressant since 1994, nothing worked. At my wits end, I decided to try ECT, hoping it would kill me, but the psychiatrist said to try EMSAM 6mg patch. He said it would work. After three weeks of feeling like I had the flu, I read all of the instructions again, and it said, "Do not cut." So I cut it from 6mg to 4mg and in 45 minutes I felt better than I had ever felt in my life. Two days in a row, I would cut 1/3 of the patch off, and on the third day, I would use the 2 pieces of 2mgs which equalled 4mgs. Two boxes lasted me three months. My life changed completely; my depression was gone, except in times of great stress, but it still worked well enough.
insomnia, anxiety, muscle twitching
It has made me increasingly anxious (especially before I cut out caffeine) and the insomnia is terrible, even now that the doctor has advised me to take the patch off around 7. At first I had really weird muscle twitches in my mouth and hands but those have gone away for the most part. It has given me increased energy and helped me out of a suicidal bout of depression, though I still feel flat and humorless. I am going up to 12mg tomorrow and hopefully that will help; I’ve read that the true anti-depressant effects don’t really kick in until higher doses. This has helped where most other anti-depressants have failed; I just wish it helped a little more.
EMSAM (SELEGILINE): Selegiline is an antidepressant (monoamine oxidase inhibitor) that treats depression by restoring the balance of certain natural substances (neurotransmitters) in the brain. Selegiline can improve your mood and feelings of well-being. This medication is a patch for use on the skin. (Sources: U.S. Centers for Medicare Services, FDA)
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