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EMSAM- Selegine Patch MAOI- Only thing that worked BP II

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I'd like to share my positive experience with EMSAM.   I'm not affiliated with the manufacturer in any way.    This is a PATCH VERSION of Selegine MAOI.

This is the ONLY antidepressant that worked for my Bipolar 2 depression in twenty years.   The SSRIs and SNRIs would work halfway, then stop working or cause anxiety (Prozac, Wellbutrin, etc).   Lexapro, Effexor, Cymbalta- all had bad side effects or were ineffective.

EMSAM is the first drug I've taken that has me absolutely depression free. I've been on it for 6 months.   It took me a while to find the right dosage (6, 9, or 12mg patches).   You leave them on for 24 hrs. 

I have also been taking Lamictal (Lamotragine) for 12 years. 

I can't believe this isn't used more widely for people who have failed using other medicines.

Side effect #1:  I can get a bad rash at the patch site that leaves me looking like a red and white checkerboard.   The squares fade after a couple of weeks.

BUT, I figured out if I do two things, I can minimize the rash.  First, spray the area with fluctonase (Flonase).   Second, open the patch and let it air out for 10 minutes; this seems to allow some of the glue/solvent to dissipate and the patch still sticks fine.

Side effect #2:   Sleep disturbance.   Sometimes I find myself not sleeping well.   If it is bad, I take off  the patch (though you are supposed to leave it on) and then after an hour I can sleep.   My pdoc said this is ok.

Side effect #3:  Activating.   I've rarely had hypomania, just a few times over the last 20 years.   The lamictal keeps that in check.   Too much Emsam would give me a bit of that manic activation- feeling too good, too much energy.

PM me if you have questions.

50 y.o. male, Bipolar 2 mostly with depression and anxiety.   Father was Bipolar 1.





Edited by Zounds
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I agree, EMSAM is an excellent med. It worked quickly but unfortunately, it seemed to work a little too well. The first time around it led to psychosis and I was almost hospitalized. The second time around I got raving mad manic again and my pdoc quickly took me off of it. The crash that followed did lead to hospitalization for a mixed episode. It caused a shift in diagnosis from BP2 to BP1. We are avoiding antidepressants altogether at the moment. 

It's interesting how activating EMSAM is compared to one of the other MAOIs, Parnate (tranylcypromine). I took Parnate after the EMSAM patch allergic reaction got to be too much to deal with. I used the same strategy you described, but I did not think to pre-treat the area with a steroid. That's clever and I'm glad it works for you. I was able to tolerate EMSAM eventually the first time around when it was paired with Saphris but I had to discontinue the latter and problems started building up. Overall - I wish the MAOI class of medications was not reserved for last resort type cases in most pdoc's offices. So many could benefit from it with a little care and attention. Especially for BP2. 

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