Emsam

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Emsam is a transdermal patch for the monoamine oxidase inhibitor (MAOI) antidepressant selegiline. It was approved by the FDA in February 2006 for the treatment of clinical depression. The primary advantage of delivering Selegiline via a transdermal patch is mitigation of the "Tyramine Effect". Normally, taking Selegiline via tablets requires dietary modification. With Emsam (at least at the lowest dosage), no such dietary modification is required.

In humans, if tyramine metabolism is compromised by the use of MAOIs and foods high in tyramine are ingested, a hypertensive crisis can result. The first signs of this were discovered by a neurologist who noticed his wife, who at the time was on MAOI medication, had severe headaches when eating cheese. For this reason, the crisis is still called the "cheese syndrome", even though other foods can cause the same problem. Foods containing considerable amounts of tyramine include fish, chocolate, alcoholic beverages, and fermented foods such as cheese, soy sauce and soy bean condiments, sauerkraut, and processed meat.

There is a list of medicines that should not be taken while using Emsam, and for 2 weeks after stopping Emsam, due to same potential hypertensive crisis occurring.^[1] Some of these medicines will have to be stopped for 1 week (or more) before an individual can start using Emsam.