Emsam is the first anti-depressant to be delivered in patch form. It's easy to use. Just apply one patch to the upper arm, upper thigh, upper abdomen or back. Wear the patch for twenty-four hours and then replace. The patches themselves are thin and made of clear plastic. They aren't conspicuous and you forget you're even wearing one after a couple of minutes. The patch comes in three sizes--6mg, 9mg, and 12mg. The largest, the 12mg patch, is about 1 3/4 inches square.
The active ingredient in Emsam is selegiline, which is an MAO inhibitor that has been in use for a long time. However, until now, selegiline has been taken strictly in pill form. Selegiline and the other MAO-Is are among the old-guard, pre-prozac line of anti-depressants. The older anti-depressants are just as effective as prozac and the other new drugs. In fact, the MAO-Is are often the most effective medications for long-term, chronic and/or treatment resistant depression. However, the MAO-Is have more side effects than prozac and the newer generation of antii-depressants.
Specifically, selegiline and the other MAO-Is have traditionally required a modified diet. Because these drugs block a certain enzyme, they make it harder for your body to break down substances in certain kinds of food, particularly aged cheeses, soy-based products, and some fermented foods and beverages. Ingesting these foods in sufficient quantities while taking selegiline or another MAO-I can cause hypertensive crisis--that is, your blood pressure can go dangerously high. People on MAO-Is are also restricted from taking certain cold medications, particularly those containing dextromethorphan, as well as the painkiller Demerol.
The beauty of Emsam is that it lessens the likelihood of dangerous side effects because the drug does not enter your body through your digestive system. You don't need to modify your diet at all if you wear the 6mg patch. And while you have to be careful not to eat the wrong things while wearing the 9mg or 12 mg patch, the likelihood of a reaction is much lower and, if you do have a reaction, it will be milder than if you take an MAO-I in pill form.
The upshot is that Emsam is a convenient and safe way of taking an MAO-I inhibitor. It can be a pain in the neck to follow a modified diet, specially if you're a fan of bleu cheese and other aged cheeses. Plus it's no fun not being able to take sudafed when you have a cold. But if you are chronically depressed and an MAO-I turns out to be the best treatment for you, then the Emsam patch is a great option and the sacrifices are worth it.
Emsam is manufactured by Bristol Myers Squibb and is covered by most insurance plans. However, since it's still new (it was first introduced in February 2006), it won't be on most plans' preferred drug formularies, so if your plan have a two- or three-tier copayment system for drugs then you'll probably pay the higher copayment. The cost of Emsam without insurance is prohibitively expensive--about five hundred dollars.