Orthostatic hypotension, which is a far more common problem with previous MAOIs than hypertensive crisis, appears to be less problematic with EMSAM.

Alzheimer-type dementia and verbal memory performances: influence of selegiline therapy. Moclobemide (sold as Amira, Aurorix, Clobemix, Depnil and Manerix) is a Reversible Inhibitor of Monoamine oxidase-A (RIMA) drug primarily used to treat depression and social anxiety. That won’t happen if you add alcohol to the mix.© The Recovery Village at Umatilla All Rights Reserved.Mixing Alcohol and Emsam (Selegiline) | Side Effects, Interactions, and BlackoutsSumming Up Side Effects, Interactions, and Blackouts of Mixing Alcohol and Emsam (Selegiline) The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. Advise patients of dietary tyramine-restriction recommendations. Although selegiline was never FDA-approved as an antidepressant in this country, there has been ample clinical experience and research data demonstrating that it is an effective antidepressant at doses between 30 and 60 mg a day (Bodkin et al, So why wasn’t oral selegiline marketed to psychiatrists? There is enough inhibition of MAO in the brain to produce a therapeutic antidepressant effect, and the absence of MAOI in the liver allows tyramine to be inactivated by intestinal MAO, thereby minimizing the danger of a hypertensive reaction.Let’s return to the FDA decision to limit the removal of MAOI dietary restrictions for the 6 mg patch only, thus creating the complicating situation for clinicians in which pushing the dose to 9 mg or 12 mg requires instructing patients to initiate the MAOI diet. Absorption through the skin sends selegiline directly into the blood stream and toward the brain, sidestepping the liver, where some of the oral MAOI is spent in blocking the breakdown of ingested tyramine. It is not approved for use in the United States, but is approved in other Western countries such as Canada, the UK and Australia (TGA approved in December 2000).
It should not be used in place of the advice of your physician or other qualified healthcare provider. The increase in blood pressure was only slightly greater for subjects gorging on tyramine with the 6 mg EMSAM patch than for those who ingested tyramine while taking the control drugs, 20 mg fluoxetine or 10 mg oral selegiline.

The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. When taking selegiline, there are specific dietary restrictions regarding foods or beverages, such as alcohol, that contain levels of tyramine.
There was enough research data and patient experience to satisfy the FDA that subjects on the 6 mg patch could eat all the tyramine they wanted without incurring any hypertensive risk.But what did the research data say about the risk of tyramine at the higher doses of EMSAM, such as 9 mg? (The FDA hearings on this issue, in all of its 243-page glory, can be viewed at http:// www.fda.gov/ohrms/dockets/ac/05/ transcripts/2005-4186T2.pdf)How did the FDA determine that 6 mg was the only safe dose? Somerset Pharmaceuticals, the original developer of the formulation, held a company-wide contest to see who could come up with the best name for their new product. If you keep your Selegiline dosage under 10mg/day it is supposed to be selective for MAO-B. Also, patients taking this prescription must follow their doctor’s recommendations for diet restrictions, because foods and beverages with tyramine can cause serious adverse reactions.Keep your doctor informed regarding any side effects which you may feel right away.

Diet and Parkinson’s Medications If you take certain Parkinson’s drugs, dietary adjustments may help your medications work better or avoid side effects. Blood glucose is not affected by eating yogurt along with selegiline (Emsam) because it does not affect glucose regulation.

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