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To reduce your risk of side effectsyour doctor may start you at a low dose and gradually increase your doseUsuallyyour daily dose will not be more than 12 milligramsOnce your condition improves and you are better for a whileyour doctor may work with you to reduce your regular doseFollow your doctor’s instructions carefullyDo not apply more patches or leave the patch on for longer than prescribedYour condition will not improve any faster and your risk of side effects will increase.
How effective is EMSAM in treating comorbid anxiety disorders in MDDOne of the failures in the development of EMSAM was not evaluating this drug in anxiety disorderseither primary or secondary to MDDEven where an anxiety disorder was secondary to MDD as was permitted in three of the four published double-blind clinical trials111214 the effect of EMSAM on the anxiety disorder was not presentedEven the actual comorbid anxiety disorders included and the number of cases in each disorder were not described in the reportsAn important analysis may have been missed since earlier literature on MAOIs suggested that they were very effective in anxiety disorders43 It is also remotely possible that EMSAM may not only be ineffective for anxiety disorders but might exacerbate themFor examplefluoxetinean SSRI antidepressanthas been reported to induce anxietyjitteriness syndromein a subset of patientsparticularly those who have anxiety disorders44 Clearlyknowing what effect EMSAM has on comorbid anxiety disordersa post hoc analysis on the clinical trial data would help answer this important clinical questionis of clinical relevanceThusa post hoc analysis awaits.
If a Emsam patch falls offtry sticking it back into placeIf it does not stick wellput on a new patch and leave it on only for the rest of your wearing timeDo not change your patch removal schedule.
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