Posted by laima on December 21, 2006, at 10:49:30
In reply to Re: Oral dosing equivalence is very, very high » laima, posted by psychobot5000 on December 21, 2006, at 2:17:30
I used the oral first, then moved to Emsam when it became available. Actually though, I'm not convinced that the transdermal delivery is very even, because heat affects it, how well it sticks affects it, sometimes it rumples up- I even wonder if different kinds of skin on different parts of the body affect how well it is absorbed. Sometimes it just plain falls off, especially in summer. I definately agree that the oral version is more stimulating. But my doctor felt very strongly that the Emsam would do more and be "more available" than the oral version of selegeline. I use a small amount of adderall with it, and that wasn't necessary with the oral. He had some remote hand in reviewing Emsam, too-sounds like a lot of consultants involved! Small world. Interestingly, the longer it's been out, the less sure anyone seems to be about what the exact equivalence between the oral and patch is.
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> > Yet, my knowledgeable doctor told me that the 6mg Emsam was roughly equivalent to 20 mg oral selegeline- which is what I was using before starting Emsam. The switch was very smooth. If anything, I found the oral version of 20 mg to be more potent. I eventually had to start the 9mg Emsam.
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> It's hard to know with certainty, but I used to think that 20mg oral was equivalent to 6mg transdermal--I now believe this to be a misunderstanding. You see, the 6mg patch actually contains 20mg selegiling, but if you wear it for 24 hours, an estimated 30%, or about 6 mg, will actually be absorbed. This is where the 6/20 mg equivalence comes from, I believe.
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> However, with the oral selegiline you have the amphetamines, and they are (often) beneficial for mood and motivation, so there is that added benefit. Also, the blood-levels spike suddenly, and maybe that's good too. I took 20mg oral selegiline daily for many months, and definitely found it beneficial. But a doc I spoke to once (who worked with developing EMSAM) explained to me that the blood-levels were not nearly as high from 20mg oral tablets as they would be from any EMSAM patch.
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> Glad to hear that the oral was a good replacement for you!
poster:laima
thread:703921
URL: http://www.dr-bob.org/babble/20061217/msgs/715424.html