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Even where an anxiety disorder was secondary to mdd as was permitted in three of the four published double-blind clinical trials, 11,12,14 the effect of emsam on the anxiety disorder was not presented.

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The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotoninExamples include street drugs such as MDMAecstasyStJohn’s wortdextromethorphancertain antidepressantsincluding SSRIs such as fluoxetine/paroxetineSNRIs such as duloxetine/venlafaxineTCAs such as amitriptyline/doxepincertain narcotic medicationssuch as meperidinemethadonepentazocinepropoxyphenetramadoltapentadolamong othersThe risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Many drugs can interact with selegilineand some drugs should not be used togetherTell your doctor about all your current medicines and any you start or stop usingespecially:

Be sure to remove the old patchfold it in half so it sticks to itselfand throw it away out of the reach of children and petsDo not touch the sticky side with your fingersWash your hands with soap and water after handling the patch.

Tell your health care professional if youhave high blood pressure have or had mania or bipolar disordermanic depressionhave or had seizures or convulsions drink alcohol have any other medical conditions are or intend to become pregnant are breastfeeding or intend to breastfeed Tell your doctor about all medicines you takeincluding prescription and non-prescription medicinesvitamins and herbal supplementsEMSAM and some medicines may interact with each othermay not work as well or may cause serious side effects when taken together.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndromeThe risk increases if you are also taking other drugs that increase serotoninso tell your doctor or pharmacist of all the drugs you takeGet medical help right away if you develop some of the following symptomshallucinationsunusual restlessnessloss of coordinationfast heartbeatsevere dizzinessunexplained feversevere nausea/vomiting/diarrheatwitching muscle.

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