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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
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. 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)?
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.
- Scott
Posted by Phillipa on December 19, 2012, at 9:30:49
In reply to Re: Stopping Emsam 6mg Cold Turkey after 2 weeks ? » LucidDreamer, posted by SLS on December 19, 2012, at 6:50:45
I'm assuming your doc is switching your meds. Didn't your doc give you instructions? And if your doc do you have the prescription for parnate yet? As if you do is there a starting date? Or is this your plan? How come you decided to go off Emsam after two weeks? Are you having side effects? Phillipa
Posted by alchemy on December 19, 2012, at 17:32:03
In reply to Re: Stopping Emsam 6mg Cold Turkey after 2 weeks ? » LucidDreamer, posted by SLS on December 19, 2012, at 6:50:45
You may be perfectly fine going turkey. I am more sensitive to withdrawing from meds than starting them. So as any fyi, my withdrawal from 9mg of emsam resulted in my first exposure to what extreme anxiety was like & a day at the hospital. So if u notice extra anx, that might be why. But dont let that scare u. My body is weird.
Posted by LucidDreamer on December 19, 2012, at 21:17:05
In reply to Re: Stopping Emsam 6mg Cold Turkey after 2 weeks ?, posted by alchemy on December 19, 2012, at 17:32:03
Thank you to all those that replied. This really helped.
This is the end of the thread.
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