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Is this Emsam for SA?

It's marketed as an antidepressant. It's selegeline, a MAO-B inhibitor used to treat Parkinson's disease. It's been around in pill form for a couple decades.

This patch received much hype a number of years ago when it first hit the market, being hailed as some great breakthrough; an MAOI without the pain in the a** dietary restrictions that turn off so many doctors & patients to MAOIs. (To be fair, there are MAOI fans who will tell you the dietary restrictions aren't all the restrictive and not really a big issue with Nardil & Parnate.)

I can't recall ever hearing anybody say it worked for their SA so far and I've certainly read about meds quite a bit on this forum for years now. I have no personal experience with it, largely because I don't care to part with $530 a month. Emsam is anything but cheap for those of us who lack insurance to cover the obscene cost.

If it works well for SA one has to wonder why we haven't seen it in use for SA for a long time. This patch is just a new way to absorb an old drug.

 

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If you can get a script for selegiline, you could just ask for a generic pill form at the pharmacy (or order it online).

In my experience it does not help anxiety, but can be useful if combined with anxiolytics (as long as interactions are kept in mind).

I just looked up the price differential between patch & generic capsule form out of curiosity.

9 mg patch x 30 = $529

5 mg capsule x 60 = $29

That's a $6,000 a year difference, an amount most people would consider quite significant if coming out of their pocket.

What interactions would have to be kept in mind? Were you thinking of some specific drug(s) that it would not work with? I'm not familiar with this particular MAOI, but it seems like the Nardil & Parnate the drugs that you don't want to mix with them basically are any stimulant, while benzos are fine. And in 2009 an anxyolitic really means a benzo. Unless one actually thinks other ADs (that shouldn't be mixed with MAOIs) have some anxyolitic effect -- a claim that I've never been able to substantiate with personal experience.

 

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In my experience it does not help anxiety, but can be useful if combined with anxiolytics (as long as interactions are kept in mind).

How would you rate it as far as antidepressant effect?

And do you think that taking it via patch vs orally would in any way change how effective or ineffective it is on depression?

In my price comparison above I did 2 x 5 mg capsules a day vs a 9 mg a day patch. I used that comparison since 5 mg is the only size the oral form comes in and is roughly the same amount as the 9 mg patch. I'm not sure if the potency would equal though due to different means of administration. Any thoughts? Just like morphine shot into a vein has a higher potency than an equal mg amount taken as a pill.