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Emsam (selegiline transdermal arrangement) is a transdermal patch using the monoamine oxidase inhibitor (MAOI) selegiline. Selegiline, in small doses, is most commonly reach-me-down in the treatment of Parkinson's disease. It is also effective in higher doses for the treatment of critical depressive disorder. On February 28, 2006 the FDA approved EMSAM for the treatment of major pit.

Inception & Development

Emsam's development was spearheaded by J. Alexander Bodkin, M.D. , Headman of the Clinical Psychopharmacology Research Program at McLean Hospital in Belmont MA, in conjunction with Harvard Medical Devotees. Currently, it is the only MAOI on the market used in the treatment of depression that is concentrating through the skin into the blood stream and thereby to the central nervous plan.

The patch "is a matrix containing three layers consisting of a backing, an... adhesive poison layer, and a release liner that is placed against the skin." The primary upper hand of delivering selegiline in this manner is to bypass the gastrointestinal tract and liver, specifically the minor intestine, thereby limiting the chance of hypertensive crisis (very high pike in blood pressure possibly leading to stroke).

"Despite long-standing concerns concluded hypertensive reactions,... (MAOIs) have grown in popularity... (and) the chance of hypertensive episodes is less than 1%."

Food Intake Restrictions

The dietary obstreperous was first discovered by a neurologist whose wife was taking an MAO inhibitor. After eating doggedly cheese, which is rich in tyramine, she would get severe headaches; thus, her keep's discovery of these spikes in blood pressure. For this reason, the crisis is that time called the "cheese syndrome", even though other foods can cause the unchanging problem.

When an MAOI is taken orally, and an individual ingests such tyramine elaborate foods, the body can not properly regulate the additional tyramine. Therefore, dietary modifications are compulsory. Foods containing considerable amounts of tyramine include: air dried, old and fermented meats, sausages and salamis; pickled herring; any spoiled or improperly stored vital part, poultry and fish; spoiled or improperly stored animal livers; broad bean pods (fava beans); all tap beers, and other beers that be experiencing not been pasteurized; concentrated yeast extract (such as Marmite); most soybean products (including soy nerve and tofu); aged cheeses (not processed cheese); sauerkraut; and over-the-counter supplements containing tyramine.

Emsam Advantages

Due generally to the availability of the newer SSRIs and SNRIs, which are viewed to have more medically compassionate side effects in the treatment of depression, psychopharmacologists and psychiatrists have avoided prescribing MAOIs because of the conceivability of hypertensive crisis. With Emsam, taken at the lowest dose of 6 mg every 24 hours, no dietary modifications are required by the FDA, and the unintentionally of such a side effect due to diet is eliminated.

In addition to the lack of dietary restrictions at the 6mg/24h administer, Emsam offers another benefit. It is a continuous delivery system, keeping the medication at a firm level in the body over time, although there is no evidence that this makes a unlikeness in terms of the efficacy or side effects of this medication. Generally, oral medication can not keep an eye on a steady dose in the blood stream.

Emsam is also valuable in the treatment of gloom that is not alleviated by the more commonly used selective serotonin reuptake inhibitors (SSRIs), dual serotonin and norepinephrine reupatake inhibitors (SNRIs) and tricyclic antidepressants (TCAs).

Kind of surprisingly, clinical trials done with MAOIs do not find that they are more functioning than other antidepressants when they are tested in large groups of people. However, for trustworthy individuals, especially individuals who have not done well on other antidepressants, a MAOI may be most skilfully. MAOIs are thought to be particularly effective in what has been called "atypical" sadness. Atypical depressions are characterized by an increased need for sleep, increased appetite, and increased dangerousness of depressive symptoms towards the end of the day.

Usage

The patch is changed once daily. There may be a answer to the adhesive on the skin at the site of application. Patients are encouraged to use an adhesive remover: large mineral oil, Vaseline or an over-the-counter product such as dermatology recommended TRIAD mark adhesive tape remover pads. A new patch is placed on a different site. The parasynthesis of adhesive remover, and placing each patch on a new area of skin, is to discourage any dermatological prevail upon for discontinuance of the patch.

Using rubbing alcohol or hydrogen peroxide to clean the overlay of oils and dirt before applying a patch can increase the likelihood of proper adjunct for the duration of each 24 hour period. Immediately after applying a lot it can be helpful to use the pressure and body heat of the palm of the hand to enhance proper adhesive telephone.

All of the dietary restrictions are currently required by the FDA, as a precaution, at the higher 9 mg/24h and 12 mg/24h doses of Emsam.

Medication Interactions

Exceeding-the-counter items that can not be used while on Emsam include: St. John's Wort; products containing dextromethorphan such as cough and unemotional preparations; decongestant medicines; and diet pills or herbal weight loss products. Caffeine and chocolate can simply be consumed in small amounts.

There are prescription medications that can not be taken while using Emsam, and for 2 weeks after stopping Emsam. Some medications necessity not be taken for 1 week (or more) before an individual can start using Emsam.

Medications that can not be captivated because they can cause serotonin syndrome include: (SSRIs), (SNRIs), (TCAs), other MAOIs, mirtazapine, bupropion, meperidine, analgesics such as tramadol, methadone, propoxyphene, cyclobezaprine and uttered selegiline. The use of Emsam is contraindicated for use with sympathomimetic amines, including amphetamines as well as faint products and weight-reducing preparations that contain vasoconstrictors (e.g., pseudoephedrine, phenylephrine, phenylpropanolamine, and ephedrine). Carbamazepine and oxcarbazepine are also contraindicated.

Patients prepossessing Emsam should not undergo elective surgery requiring general anesthesia or be allowed local anesthesia containing sympathomimetic vasoconstrictors.

Emsam Name Origin, Producer & Distributor

The acronym Emsam is derived from the names Emily and Samuel. They are the children of Mel Sharoky, M.D., CEO of Emsam's fabricator, Somerset Pharmaceuticals, Inc., The prescription medication is distributed by Bristol-Myers Squibb out of Princeton, NJ.

Surface links

  • Everything You Ever Wanted to Know about EMSAM and more.
  • FDA Approves Emsam (selegiline) as Initially Drug Patch for Depression.
  • Andrew Bridges, Associated Press (2006). "Coating patch for mood disorders approved". The Boston Globe March 01, 2006
  • Bodkin JA, Amsterdam JD (Nov 2002). "Transdermal selegiline in paramount depression: a double-blind, placebo-controlled, parallel-group bookwork in outpatients". Am J Psychiatry 159 (11): 1869–75. doi: 10.1176/appi.ajp.159.11.1869 . PMID 12411221 . http://www.ajp.psychiatryonline.org/cgi/content/squarely/159/11/1869 .  
  • Bristol-Myers Squibb Company EMSAM information for U.S. residents only.
  • Hitti, Miranda (reviewed bt Chang, M.D. Louise) (2006-02-28). ""FDA OKs Area to Treat Depression, Using EMSAM in Lower Doses May Avoid Concerns Far Drug Interactions"" ( – Scholar search ). Medicine Net.com :WebMD, Inc. . http://www.medicinenet.com/teleplay/main/art.asp?articlekey=60223 .  
  • Tong TG, Saklad SR (1994). "What foods you should steer clear of on MAOIs" (MAO-I's Dietary Restrictions)
  • Walker SE, Shulman KI, Tailor SA, Gardner D (Oct 1996). "Tyramine comfort of previously restricted foods in monoamine oxidase inhibitor diets". J Clin Psychopharmacol 16 (5): 383–8. doi: 10.1097/00004714-199610000-00007 . PMID 8889911 . http://meta.wkhealth.com/pt/pt-nucleus/template-journal/lwwgateway/media/landingpage.htm?issn=0271-0749&volume=16&matter=5&spage=383 .  
  • William J. Cromie (November 7, 2002). "Bodkin is patching up depression". Harvard University Gazette (photo of Dr. Bodkin displaying straight.)
  • Feiger AD, Rickels K, Rynn MA, Zimbroff DL, Robinson DS (Sep 2006). "Selegiline transdermal system for the treatment of principal depressive disorder: an 8-week, double-blind, placebo-controlled, extensile-dose titration trial". J Clin Psychiatry 67 (9): 1354–61. PMID 17017821 . http://article.psychiatrist.com/?ContentType=START&ID=10002718 .  
  • Patkar AA, Pae CU, Zarzar M (Jun 2007). "Transdermal selegiline". Drugs Today 43 (6): 361–77. doi:10.1358/dot.2006.43.6.1050794 (torpid 2008-12-15). PMID 17612708.  
  • NIH Medication Information: EMSAM.
  • NIH Medline Information: Serotonin Syndrome

References

  1. ^ a b c d Patkar AA, Pae CU (May 2006). "Transdermal selegiline: the new initiation of monoamine oxidase inhibitors". CNS Spectrum 11 (5): 363–75. PMID 16641841 . http://cnsspectrums.com/aspx/articledetail.aspx?articleid=400 .  
  2. ^ Cruzan, Suzanne ( 28 February 2006 ). "FDA Approves EMSAM (Selegiline) as In the first place Drug Patch for Depression". U.S. Food and Drug Administration, FDA News P06-31 . http://www.fda.gov/bbs/topics/Scandal/2006/NEW01326.html .  
  3. ^ Andrew Bridges, Associated Press ( March 1 , 2006 ). "Derma Patch for Mood Disorders Approved". The Boston Globe . http://www.boston.com/hearsay/nation/articles/2006/03/01/skin_patch_for_mood_disorders_approved/ .  
  4. ^ a b c d e f "FDA Approves EMSAM(R) (selegiline Transdermal Set), The First Transdermal Patch For The Treatment Of Major Depressive Disorder". Medical Intelligence Today . 6 March 2006 . http://www.medicalnewstoday.com/articles/38883.php .  
  5. ^ "Alexander J. Bodkin, M.D." . http://www.mclean.harvard.edu/concerning/bios/detail.php?username=abodkin . Retrieved on 2007-09-08 .  
  6. ^ a b c Frampton JE, Plosker GL (2007). "Selegiline transdermal routine: in the treatment of major depressive disorder". Drugs 67 (2): 257–67, discussion 266–7. doi: 10.2165/00003495-200767020-00006 . PMID 17284087.  
  7. ^ a b Tong TG, Saklad SR (1994). What foods you should sidestep on MAOIs (MAO-I's Dietary Restrictions) . http://deoxy.org/maoidiet.htm .  
  8. ^ William J. Cromie (2002-11-07). "Bodkin is Patching up Dimple" . http://www.news.harvard.edu/gazette/2002/11.07/11-patch.html . Retrieved on 2007-09-08 .  
  9. ^ "Hypertensive Disaster" . http://www.mayoclinic.com/health/hypertensive-crisis/AN00626 . Retrieved on 2007-09-15 .  
  10. ^ a b Rapaport MH (2007). "Dietary restrictions and tranquillizer interactions with monoamine oxidase inhibitors: the state of the art". Journal of Clinical Psychiatry 68 (8): 42-6. PMID 17640157.  
  11. ^ a b Lavin MR, Mendelowitz A, Kronig MH ( August 1 , 1993 ). "Impromptu hypertensive reactions with monoamine oxidase inhibitors". Biological Pysychiatry 34 (3): 146-51. PMID 8399806.  
  12. ^ "Persistent Delivery for Once-Daily Application". Bristol-Myers Squibb : 1–8. June 2007 . http://www.bms.com/cgi-bin/anybin.pl?sql=PI_SEQ=112 . Retrieved on 2007-09-14 .  
  13. ^ Walker SE, Shulman KI, Accommodate SA, Gardner D (1996 October). "Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets". Yearbook of Clinical Psychopharmacoly 16 (5): 383–8. doi: 10.1097/00004714-199610000-00007 . PMID 8889911.  
  14. ^ Feinberg SS, Holzer B (June 1997). "Feinberg SS, Holzer B". Chronicle of Clinical Psychopharmacology 17 (3): 226. doi: 10.1097/00004714-199706000-00016 . PMID 9169971.  
  15. ^ Wing YK, Chen CN (June 1997). "Wing YK, Chen CN". Annual of Clinical Psychopharmacology 17 (3): 227-8. PMID 9169972.  
  16. ^ Fiedorowicz JG, Swartz KL (July 2004). "The role of monoamine oxidase inhibitors in contemporaneous psychiatric practice". Journal of Psychiatric Practice 10 (4): 239. doi: 10.1097/00131746-200407000-00005 . PMID 15552546.  
  17. ^ Krishnan KR (2007). "Revisiting monoamine oxidase inhibitors". Catalogue of Clinical Psychiatry 68 (8): 35-41. PMID 17640156.  
  18. ^ Patkar AA, Pae CU, Zarzar M (June 2007). Transdermal selegiline . 43 . p. 361-77. PMID 17612708.  
  19. ^ Feiger AD, Rickels K, Rynn MA, Zimbroff DL, Robinson DS (September 2006). "Selegiline transdermal arrangement for the treatment of major depressive disorder: an 8-week, double-blind, placebo-controlled, conformable-dose titration trial". Journal of Clinical Psychiatry 67 (9). PMID 17017821.  
  20. ^ "Serotonin Syndrome" . http://64.233.169.104/to order?q=cache:Y0Xnct_0GkQJ:www.nlm.nih.gov/medlineplus/ency/article/007272.htm+%22serotonin+syndrome%22&hl=en&ct=clnk&cd=3&gl=us . Retrieved on 2007-09-15 .  
  21. Writing about Buy Selegiline has led us to learn unknown things about Buy Selegiline. This is the main reason for us to write this article; to make it fruitful to you!

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