How Long Does Emsam Stay in Your System?

Emsam is a brand name of the prescription medication selegiline. Selegiline is used to treat some variations of major depressive disorder (MDD). Emsam is also part of a commonly prescribed treatment plan for managing symptoms of Parkinson’s disease.

When Emsam is prescribed to treat depression, it’s issued in the form of a transdermal patch. Oral Emsam, taken in pill form, is prescribed to patients with Parkinson’s disease to mitigate the severity of symptoms by boosting dopamine production.

Selegiline is prescribed to patients with depression after they do not respond well to other medications like selective serotonin reuptake inhibitors (SSRIs) and tricyclics. SSRIs and tricyclics have a higher rate of effectiveness and come with fewer complications than MAO inhibitors such as Emsam.

The oral form of selegiline comes with an increased risk for hypertensive episodes when mixed with foods that contain tyramine. The patch was created to reduce the occurrences of such conflicts. Patients taking low-to-moderate doses of the patch can safely eat foods containing tyramine. At high doses, individuals are advised to eat a diet low in tyramine. Foods that are high in tyramine include cheese, processed meats, and chocolate.

Other antidepressants and medications that boost levels of serotonin in the brain should not be taken while being treated with Emsam. Combining selegiline with SSRIs or tricyclics can lead to serotonin overload and psychosis.

Selegiline is not scheduled as a controlled substance and is available by prescription across the US. In some countries, such as Japan, Emsam is considered a controlled substance because of the drug’s structural similarity to amphetamine. Even so, selegiline can be obtained through a prescription or special government license in Japan.

For a time, some manufacturers of the recreational drug ecstasy were cutting their products with selegiline. Producers of the illicit pills were likely attracted to selegiline’s structural and behavioral similarities to amphetamine.

Methylenedioxymethamphetamine (MDMA) is the main component in pressed ecstasy pills that induces the drug’s characteristic euphoria by boosting serotonin. Combing MDMA with Emsam is a potentially hazardous combination that can result in serotonin syndrome, a dangerous condition with the potential to cause psychosis and permanent brain damage.

Selegiline belongs to a class of medicines called monoamine oxidase inhibitors (MAO inhibitors). MAO inhibitors inhibit the breakdown of monoamine neurotransmitters in the brain. Emsam is an irreversible, selective MAO inhibitor. The irreversible component means that selegiline permanently alters the functioning of neurotransmitters even after treatment is stopped. Selective, in this context, means that the drug targets certain MAO pathways but not others. Selegiline affects MAO-B pathways and disregards MAO-A pathways.

At high doses, however, selegiline will begin impacting all MAO pathways and affect a wider variety of neurotransmitters. At low-to-moderate doses, Ensam’s effects are focused on increasing the expression of the neurotransmitters dopamine and norepinephrine. Dopamine’s primary function is to increase focus and motivation. Norepinephrine plays a similar role in the brain and contributes to a variety of functions from digestion to mental health.

The mean half-life of selegiline’s three metabolites (R(-)-N-desmethylselegiline, R(-)-amphetamine, and R(-)-methamphetamine) ranges from 18 to 25 hours. This data was calculated from the intravenous administration of selegiline at 1.4 L per minute. When Emsam was applied as a transdermal patch, approximately two to ten percent of the solution was recovered in the urine and feces. 63% of the drug remained unabsorbed, and 25% remained unaccounted for.

From the time of the last dose, the residual effects of selegiline continue to directly influence metabolism and brain chemistry for two to three weeks. This is how long it takes for enzyme production to return to normal. However, the long-term effects of Emsam on brain chemistry are irreversible. Selegiline is a type of MAO inhibitor that permanently inhibits the breakdown of several key neurotransmitters in the brain that relate to depression.

When taken orally, selegiline has a bioavailability of up to 10%. Because Emsam is fat-soluble, it’s more easily absorbed by the body when consumed with fatty foods like coconut oil, beef, or fish. Emsam is excreted in the feces and urine between 18 and 25 hours following ingestion.

Oral Emsam is primarily metabolized in the liver and gut wall. Its metabolites bind to plasma proteins at a rate of 94%. Transdermal selegiline results in significantly higher absorption of the drug and significantly higher exposure to metabolites that would be excreted through the feces and urine.

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