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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by kiddo718 on July 1, 2009, at 7:12:41
Hi - Has anyone found a way to help reduce/prevent the raised, red itchy circles on my skin from the Emsam patch? Each mark that it leaves behind seems to last about 3-4 weeks. Except for this side effect, the combination of Emsam + less than 1 mg of Abilify seems to be working without the more debilitating side effects of previous combinations that I've tried over the last 20 years. (Most recently before this, extreme sleep problems on Nardil+Abilify, and hot flashes/weakness/heart racing for about an hour after each time I took Parnate.) So I am hoping there is a way to make this work, but after a month I have so many marks on my skin that its starting to look kind of funny. My doctor suggested that I try an antihistamine like zyrtec but it hasn't helped. Has anyone else found a solution to this?
Posted by Larry Hoover on July 1, 2009, at 9:40:12
In reply to Emsam skin reactions, posted by kiddo718 on July 1, 2009, at 7:12:41
The reaction you describe is most probably contact dermatitis caused by the adhesive. I've looked into the subject pretty thoroughly in the past, and I never found any solution for the problem, because it's a sensitization reaction. Once you're sensitized.....
The value in using transdermal delivery of selegiline is that it bypasses first pass metabolism in the gut and liver. Some people have suggested that liquid or quick-dissolving tablets placed under the tongue might have similar bypass characteristics.
Lar
Posted by Phillipa on July 1, 2009, at 10:59:41
In reply to Re: Emsam skin reactions » kiddo718, posted by Larry Hoover on July 1, 2009, at 9:40:12
When first out my pdoc had one patient on it same problem as you she sent her to a dermatologist and she had to discontinue. Some here used cortisone cream if rash not bad. Good emsam of this site. Phillipa and welcome to babble as see your new
Posted by Sigismund on July 2, 2009, at 20:20:19
In reply to Re: Emsam skin reactions » kiddo718, posted by Larry Hoover on July 1, 2009, at 9:40:12
I wonder if the skin reactions are more common in the heat of summer?
I've heard that about testosterone patches.
Posted by Larry Hoover on July 3, 2009, at 19:49:41
In reply to Re: Emsam skin reactions, posted by Sigismund on July 2, 2009, at 20:20:19
> I wonder if the skin reactions are more common in the heat of summer?
>
> I've heard that about testosterone patches.I believe that to be the case. Two possible causes that I can think of are: a) increased blood flow to the skin due to dilation of capillaries in response to the environmental temperature; and, b) possible cross-sensitization due to environmental triggers, e.g. pollen or volatile organic hydrocarbons or photochemical smog.
Or both.
Lar
Posted by Iansf on July 4, 2009, at 17:42:09
In reply to Emsam skin reactions, posted by kiddo718 on July 1, 2009, at 7:12:41
I suggest you try aloe vera gel, both on the irritated skin and on any area you're going to place a new patch. Let the gel dry before putting on a patch so it isn't too slippery for the adhesive to stick. You can buy a commercial gel, or you can take a piece of the live plant and apply the gel directly. Some people seem to get a lot of help from aloe vera, and others none.
> Hi - Has anyone found a way to help reduce/prevent the raised, red itchy circles on my skin from the Emsam patch? Each mark that it leaves behind seems to last about 3-4 weeks. Except for this side effect, the combination of Emsam + less than 1 mg of Abilify seems to be working without the more debilitating side effects of previous combinations that I've tried over the last 20 years. (Most recently before this, extreme sleep problems on Nardil+Abilify, and hot flashes/weakness/heart racing for about an hour after each time I took Parnate.) So I am hoping there is a way to make this work, but after a month I have so many marks on my skin that its starting to look kind of funny. My doctor suggested that I try an antihistamine like zyrtec but it hasn't helped. Has anyone else found a solution to this?
>
>
>
>
Posted by kiddo718 on July 4, 2009, at 18:26:05
In reply to Re: Emsam skin reactions, posted by Iansf on July 4, 2009, at 17:42:09
Thank you all who have had suggestions - I will try the aloe and probably just deal with the red skin until the weather cools off and see if it gets any better. I don't really think I'm in danger of any serious allergic reaction and the skin irritation is so much less of a problem than other reactions I've had to nearly everything else that worked even a little (seizures, fevers, chronic diarrhea, enamel-destroying tooth grinding, micro-sleeps, passing out, hot flashes, and I'm sure I'm leaving something out)....
Thanks for being so welcoming too. I've been a lurker for several years and the fact that I don't regret having posted makes me a little surprised, quite relieved, and very grateful.
-K
Posted by HSP Woman on July 5, 2009, at 2:40:36
In reply to Re: Emsam skin reactions, posted by kiddo718 on July 4, 2009, at 18:26:05
Oh, I had the SAME problem. BIG, red welts. Almost had to stop using the Emsam patch.
Finally, a little dab of Mometasone Furoate 0.1% every four days or so has eliminated the red marks completely.
Now, I've been on the patch for 18 months without red marks.
I had tried many remedies before -- nothing worked. The Mometasone Furoate really works like a charm.
Good luck : - )
-Jen
Posted by softheprairie on July 12, 2009, at 0:22:39
In reply to Re: Emsam skin reactions » kiddo718, posted by Larry Hoover on July 1, 2009, at 9:40:12
> The reaction you describe is most probably contact dermatitis caused by the adhesive. I've looked into the subject pretty thoroughly in the past, and I never found any solution for the problem, because it's a sensitization reaction. Once you're sensitized.....
>
> The value in using transdermal delivery of selegiline is that it bypasses first pass metabolism in the gut and liver. Some people have suggested that liquid or quick-dissolving tablets placed under the tongue might have similar bypass characteristics.
>
> LarYes to the last sentance's reference to the same active ingredient, selegiline, in orally-disintigrating tablet form, which also bypasses the gut! It is only available in the name brand form of Zelapar, and I luckily had good coverage for it, because its price for the kind of dosing I needed (taking something like 12 or 14 pills a day of it at the 1.25 mg strength) was astronomical.
I too was very annoyed at the dermatological problems with the Emsam patches, and asked my pdoc if I could try it in another form, which is how I got to use Zelapar. I was his only person on it, I'm pretty sure.
(I referred to it as bypassing the gut, but I should say that I was instructed to treat it the same as I had the 12 mg Emsam patch and to follow the MAOI dietary restrictions to be on the safe side.)
Posted by gigantor on August 22, 2013, at 23:12:04
In reply to Re: Emsam skin reactions » Larry Hoover, posted by softheprairie on July 12, 2009, at 0:22:39
I'm on Emsam and love it for many reasons but it's very expensive and I'm about to lose my Rx coverage. It sounds like if I'm on a 6mg Emsam patch, I need 6mg in lozenges as well, is that right? Or does one change the dosage from one to the other because of the delivery system?
Posted by damnthislife on August 23, 2013, at 7:46:15
In reply to Re: Emsam skin reactions, posted by gigantor on August 22, 2013, at 23:12:04
If you're talking about taking the oral form of Selegiline as well, then yes, that would increase the over all dosage of the medication.
Keep in mind, the Emsam patch at 6mg requires no diet restriction. However, the patch has a higher dosage of Selegiline that then you think. I believe (don't quote me) it has around 20mgs of selegiline in it. So, adding an oral dosage would thus increase it even more (obviously) and possibly put you in the catagory of having to follow the diet restriction.
That said, I have been on Emsam now for almost 2 months. 6mgs for 4 weeks, and 3 weeks now on 9mgs. I have followed the diet pretty well, but have taken in parmesan cheese in small dosages. I have yet to have any reactions. I do notice that drinking caffeine will cause a rise in heart rate for a small time.
This is the end of the thread.
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