Posted by Jost on September 19, 2006, at 20:21:32
There's been discussion here about the dose of Emsam available in each patch, in general, and, more specifically, the effect of heat on amount of Emsam absorbed.
My experience indicates that the application of heat, such as in a hot tub, hot bath, heating pad, or even during vigorous exercise, can greatly increase the amount of selegeline absorbed in a short period of time.
This can lead to troublesome side effects, in my case tachycardia and an irregular heartbeat of a kind that would not be sustainable over time.
I've also noticed very negative mood and general physical tension effects after using emsam with heat.
I've had at least five (and possibly more) incidents when this has happened: once with a hot tub, once with use of a heating pad, and several times with aerobic exercise.
In the last week, I began more regular aerobic exercise. On the third or fourth day in a row, I noticed that my heart rate was varying widely (my exercise bike has a heart monitor), and heart palpitations strong enough to cause me to take my blood pressure, and record my pulse.
My heart rate was about 130 and the beat was quite irregular, coming in fast bursts. This continues on and off for five or more hours, and recurred the next day. It also recurred again when I exercised. At this point I consulted my Pdoc, who advised me to take off the patch, and was convinced that the reaction was to too high a dose of selegiline.
I reduced the dose, but yesterday, because of a muscle tightness, was using a heating pad, which happened to cover the area where I had placed the patch. Later, I again had the problem.
I also had a similar experience about a month ago with a hot tub, as well as the very uncomfortable overall mood and somatic sensations.
This overabsoption is due, I believe, to the fact that only a small percentage of the selegeline in the patch is generally absorbed (about 20%). However, under conditons of heat, it is possible that much greater amounts can be absorbed in a very short period of time, greatly increasing one's exposure to the drug. Therefore, under such conditions, side effects can occur that would not normally.
So I would caution anyone taking selegeline to check pulse rate and note other unusual reactions after application of any type of heat, or even exercise.
My Pdoc strongly recommends taking the patch off when exercising, if this problem should occur. Possibly timing the exercise so that the patch can be taken off before and replaced after exercise would be the recommended course.
Jost
poster:Jost
thread:687518
URL: http://www.dr-bob.org/babble/20060919/msgs/687518.html