Posted by SLS on December 19, 2012, at 6:50:45
In reply to Stopping Emsam 6mg Cold Turkey after 2 weeks ?, posted by LucidDreamer on December 19, 2012, at 3:49:28
> Hi, I've been taking the Emsam patch 6mg for about two weeks. I have decided to switch to Parnate. First off do I need to wait a week after stopping Emsam to be able to go on Parnate? Some places say yes others say no.
Do the people who suggest switching over immediately offer any rationale as to why this would be safe? The contraindication regarding crossing over from Nardil to Parnate involves concerns of precipitating CVA stroke. There are reports of this happening. I don't know the physiology behind this, though. Without convincing proof otherwise, I would not play with Emsam. You might be able to do it without incident, but how would you know in advance?
> And also does anyone know if I can just stop taking Emsam suddenly since it was only 6mg and for such a short period of time (2 weeks)?
I am guessing that abrupt discontinuation will be okay. You might experience some REM rebound and "brain zaps". They might be less problematic coming off of 6/24 because that dosage *probably* doesn't raise serotonin levels as much as higher dosages. However, 6/24 does inhibit MAO-A to an extent greater than was first thought.
According to the labelling of Emsam:
"Selegiline (the drug substance of Emsam) is an irreversible inhibitor of monoamine oxidase (MAO), an intracellular enzyme associated with the outer membrane of mitochondria. MAO exists as two isoenzymes, referred to as MAO-A and MAO-B. Selegiline has a greater affinity for MAO-B, compared to MAO-A. However, at antidepressant doses, selegiline inhibits both isoenzymes..."
I would try to discontinue Emsam 6/24 all at once. To be safe, I would wait 10 days between your last dose of Emsam and your initiating Parnate treatment.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1033318
URL: http://www.dr-bob.org/babble/20121217/msgs/1033322.html