Emsam and Insomnia: What Users Say

• LKW...
• January 30, 2012

For Depression "I tried EVERYTHING to get over what was first diagnosed as depression (30 years ago). About 12 years ago I started seeing a psychiatrist who thought I might be bipolar, type 2 (mostly depressive, no full-blown manic state) and started me on Emsam. It took some time-can't really remember but maybe a month but it works. Yes, there are side effects-insomnia being the worst but that dissipated in a few months. We all know that what works for one person may not for another but this is not an SSRI which can't 'touch' depression associated with bipolar. And you don't have to be bipolar for it to work. I know it's frustrating but give it a shot-maybe you'll be like me and never have to try another medicine again!"

• Anonymous
• March 1, 2012

For Depression "Emsam is by far the best antidepressant I have come across in over 20 years of treatment, in which I have been given everything under the sun. Wellbutrin was okay but was weak, edgy, and stops working after about 6 months. I have been on Emsam twice now for stints of about a year each. Unlike other antidepressants, it doesn't have that plastic, fake agitated feeling to it. Feels like natural emotions. It cuts my depression roughly in half. Still suicidal often, but not every moment of every day. I have a severe skin reaction to the adhesive that looks horrific but it's worth it. Other than that and worsening insomnia, it really doesn't have side effects. Well worth the rash. I have to stay at 6mg because the higher doses produce psychosis in me."

• Car...
• December 4, 2011

For Depression "Emsam greatly helped with my depression and anxiety. I had energy and a life again. However, I had insomnia that was very hard to treat. I tried Ambien, Lunesta, Seroquel, Ativan, and Trazodone, but nothing helped. My psychiatrist suggested Chloral hydrate."

• Boo...
• Taken for less than 1 month
• May 4, 2019

For Major Depressive Disorder "I’ve tried so many psychotropic drugs for the last 30 years, resulting in untoward side effects or ineffectiveness. My psychiatrist referred me for a second opinion med consult, and the doctor I saw put me on Emsam for my MDD. I’ve been on 6 mg for 3 weeks, and I noticed a difference in about a week. I feel like the doom is lifting, and I’m not as depressed. What amazes me is I have no flat feelings at all, which is something that has left me feeling less than human on SSRIs. I will be upping my dose after a month. Insomnia is a problem, but I have it anyway, so it's hard to tell what’s what. I’m still feeling anxious and tired, but it’s much less, and I hope with time that will get better. Also, it’s tricky to get the patch to stay on, but I found a good spot that works for me. I put mine on the top of my thigh, and that seems to be okay. So... what I’m trying to say... so far I like it!"

• Sun...
• Taken for 6 months to 1 year
• September 29, 2021

For Depression "Excellent medication for treatment-resistant, severe, recurrent atypical depression. Expensive ($2000/mo retail), but I'm on disability for lifelong depression (since age 19 - I'm 54 now), so it costs $4. Got rid of my severe, lifelong depression; made me social again - kind of like a bright light switch being turned on in a dark, forgotten room. Girlfriend says it's like 'night and day.' Side effects: insomnia treated with low-dose quetiapine (Seroquel 100-175 mg); adhesive site reaction (itchy rash) prevented by using dry skin lotion to massage into the area between the patch and skin as it is slowly peeled off. Started at 6 mg/24 hr patch and increased to 9, then 12 mg/24 hr patch (maximum dose). Psychiatrists younger than about 60 tend to have little experience prescribing and managing MAO inhibitors, of which Emsam is one; even though MAOIs are the best antidepressants for treatment-resistant, severe, recurrent depression. Emsam (selegiline), Parnate, Nardil, and Marplan are US FDA approved."

• Dia...
• Taken for 1 to 6 months
• May 29, 2020

For Major Depressive Disorder "I have been taking Emsam 6 mg for almost two months. I initially was feeling pretty good, but the last 21 days I have been very depressed and full of anxiety. I have tried almost every other antidepressant, SNRI, and mood stabilizer. I also did two rounds of TMS. I really want this medicine to work and want to stay at the 6 mg because of the possible strokes from eating foods high in tyramine. I do suffer from insomnia but take clonazepam 0.5 mg, and that has helped. Just wish I knew why I have been so depressed and full of anxiety."

• Smi...
• April 24, 2019

For Depression "I don't need to go into detail here about how terrifying going through your first depressive episode is. I was prescribed 6 mg Emsam. I didn't notice an improvement for the first three weeks. When I was bumped up to 9 mg, I began to laugh again. I was able to function again. I'm to a comparable state to where I was before my depressive episode, however, with a few alterations in my personality. The negatives: insomnia - It is rare when I am able to sleep through the night. I often wake up in the middle of the night and have a lot of difficulty falling back asleep. My psychiatrist recommended that I take off the patch before going to bed, but this put me in a really weird mood in the morning. The irritability - I notice that I get frustrated/angry much more easily now, and I never felt like this before. This medication has been an absolute lifesaver for me."

• Noo...
• Taken for less than 1 month
• March 14, 2016

For Depression "I actually struggle with the possibility of BP II. At 6 mg, I didn't have any response, positive or negative, except that it repressed my appetite, with infrequent feelings of rage, which were controllable with benzos (Ativan). At 9 mg, I began to have extreme insomnia (probably because it metabolizes as L-amphetamine or an Adderall-like substance). At this dosage, the rage I would feel was too much to handle and was very much similar to what I felt on Wellbutrin. I would caution anyone, if you have rage on Wellbutrin, you may (as others have anecdotally said) have feelings of rage on Emsam as well. It's worth a try still, however, when I wasn't feeling intense anger, at 9 mg, I did feel better. Best of luck."

• hap...
• Taken for 1 to 2 years
• March 15, 2017

For Major Depressive Disorder "The side effects of this drug have destroyed my well-being, and I am not exaggerating when I say that. Everything was going very well the first 2 months I was on the drug. But then the insomnia started. And then came the irritability. Then the short temper. Then the escalated anger. And then came the panic attacks, leading to dependency on Xanax XR. Depression came back anyway when the insomnia started. My social anxiety has returned in a big way. The lowest dose was too activating for me. I would not recommend this medication for anyone who suffers from anxiety along with depression, even if your depression is worse than your anxiety. I've been off it for almost a week. Pro: transdermal = bypasses the digestive tract."

• Emi...
• Taken for 1 to 6 months
• March 7, 2022

For Depression "I’ve had every side effect there is with Emsam. It started with the 6 mg, but I thought they’d go away. The insomnia was already normal for me with the depression, but it’s been way worse. Impulsivity, intense irritability, chronic constipation, blackouts upon standing, weight gain, exhaustion. We went to the 12 mg because I was still depressed, and even though the depression went away, the side effects progressed. When my feet and legs swelled up to where I couldn’t wear shoes, I was done. Down to 9 mg, no better, down to 6 mg, still not sleeping. This was my “last resort.” Devastated."

• Tes...
• Taken for 10 years or more
• September 21, 2022

For Major Depressive Disorder "I have been on Emsam since 2007, when it first came out. Started on a 12 mg patch, then down to 9, and then down to 6, which I have been on for 10+ years. I tried all SSRIs with minor and limited-time help. It has been a true blessing. Insomnia has been a constant problem. Now taking 300 mg gabapentin and 0.25 lorazepam with the patch about 9 p.m. and falling asleep after midnight. Sleeping well most nights. Tremors and fine motor skill weakness are my main problematic symptoms. I am a 74-year-old female. I would highly recommend Emsam. Not many problems with food or medicine. I am careful with food and drink selections and have had a few reactions. Hair dye with MSG, eye drops for numbing caused me to spike in BP, also, I did have a hospital stay for a spike due to old mushrooms, but not bad for this many years."

• Anonymous
• December 22, 2010

For Depression "It really does work, the one side effect you have to overcome is it makes it difficult to sleep at night."