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Re: Emsam » queenie star

Posted by Larry Hoover on January 28, 2008, at 13:19:26

In reply to Emsam, posted by queenie star on January 27, 2008, at 17:50:31

> I've been on numerous medications for depressionfor over 20 yrs. Iguess they have quit working; all SSRI'S. Iam to start EMSAM. I'm looking forward to it. I'd like to hear from anyone who has beeen on it, or any MAO'S. Also; my Dr. wants to cut the patch in half, and continue with medication Tegretol, which I've been on for years. Tegretol is on the list of medications NOT to take because serious adverse

I would like to suggest to you that your first responsibility is to your own safety. Don't begin a drug therapy while you have questions such as you have. In other words, don't consent until you're informed. You should discuss this with your doctor, once more.

I looked into the combination of Tegretol and MAOI drugs, and with selegeline in particular. I found no mention of an interaction with Tegretol in the Parnate or Nardil monographs. In the Tegretol monograph, they make brief mention of a theoretical interaction with MAOIs. In the oral selegeline (Eldepryl) monograph, no mention of Tegretol appears. However, in the transdermal selegeline (Emsam) monograph, they do report an actual test for an interaction between the two. Although Tegretol usually decreases the blood concentration of drugs it interacts with (via enzyme induction), Tegretol was found to increase the expected blood concentration of selegeline when a patient stable on Tegretol was exposed to the Emsam patch. See: http://www.rxlist.com/cgi/generic/emsam_ad.htm#DI
under the heading 'Carbamazepine', in 'Drug Interactions'.

So, what's that mean in practise? You'd get more bang out of the Emsam patch, so cutting one in half is a good starting point. It would appear that your doctor knows precisely what to expect. But, you need to talk about it with him, to be sure. To be informed, before you consent.

Lar

 

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