The incidence of squamous cell carcinoma was slightly increased on treated skin of mice administered the high dose. No gender differences have been observed in the pharmacokinetics or metabolism of selegiline during administration of EMSAM.No adjustment of EMSAM dosage is required in patients with mild liver impairment (Child-Pugh 5-6 points) or moderate liver impairment (Child-Pugh 7-9 points). So i’ve been taking it everyday. Do not give EMSAM to other people, even if they have the same symptoms that you have. I’m a male in my 20’s, and have had PSSD since 2012 after a two and a half-year streak of taking fluvoxamine. It’s impossible to determine the exact cause of each recovery, and there are often problems in each case. It’s reassuring to read everyone’s comments and know I’m not alone. Wear only one transdermal system at a time.For more detailed instructions, read enclosed Medication Guide.Dosage: Apply one (1) transdermal system every 24 hours. My doctor then switched me to a drug called brintellix, which upon taking it any sexual function remaining was now completely gone. There were no clinically significant changes in blood pressure during pseudoephedrine administration alone, or in combination with EMSAM In subjects who had received EMSAM 6 mg per 24 hours for 10 days, co-administration with risperidone (2 mg per day for 7 days), a substrate for CYP2D6, did not affect the pharmacokinetics of selegiline or risperidone Warfarin is a substrate for CYP2C9 and CYP3A4 metabolism pathways. A high-tyramine meal is considered to contain up to 40 mg of tyramine. I mean, the only thing people want to know if that you'd be up to having sex with males, females, and/or both/others. Transdermally absorbed selegiline (via EMSAM) is not metabolized in human skin and does not undergo extensive first-pass metabolism. i dont know 2 stories that were identical so everyone will be different going through this. Post-SSRI Sexual Dysfunction [PSSD] is a term covering a wide variety of sexual side effects of SSRI antidepressant medications which persist after discontinuation or arise during the downtaper, withdrawal, or post-withdrawal period. The only difference is the functional asexual might have memories of being a sexual, but at some point, it becomes so alien that those memories may very well be of another person, so that difference can be nullified. I’m just going to stay as active and healthy as possible.I also have the same condition and have been like this now since last August 2017. There is no evidence I suffered from a mental illness, other than middling grades. So while each by itself might be subject to objections and inconsistencies, together they might point to trends that will help us crack the code of PSSD. I was on sertraline 100 for about 8 years. Due to the more limited data available for EMSAM 9 mg per 24 hours and the results from the Phase I tyramine challenge study in fed volunteers administered EMSAM 12 mg per 24 hours, patients receiving these doses should follow Following dermal application of EMSAM to humans, 25% to 30% of theFollowing dermal application of radiolabeled selegiline to laboratory animals, selegiline is rapidly distributed to all body tissues. I mean, the only thing people want to know if that you'd be up to having sex with males, females, and/or both/others. EMSAM has not been studied in patients with severe liver impairment (Child-Pugh 10-15 points). My PSSD seems to have gotten worse. It feels like I am dead from inside. It feel like it will never be the same though. Furthermore, it has a positive effect on libido, especially among elderly men. In an Selegiline (the drug substance of EMSAM) is an irreversible inhibitor of monoamine oxidase (MAO), a ubiquitous intracellular enzyme. Now its beed 5 years since i stop to take that Paxil, which I took for only 1 week. Pssd is not only sexual functions. I suffered from GAD and social anxiety disorder. Layer 2 is the Adhesive/Drug Layer. ]Store at 20° to 25°C (68° to 77°F). Slowly my libido went down, with periodic spurts of erectile dysfunction. I am very helpless right now. I had a blood test and it showed I was an overmethlator, meaning my body is producing too much serotonin. However, it is also important to note that recovery might occur over a period of years and most people probably recover sooner.Perhaps the best way to frame the risk is to note that PSSD may occur after going off antidepressants (even with no other apparent withdrawal symptoms) and recovery is a bell curve, with most people recovering with a year or two, others recovering within 10 years, but a minority at the extreme right tail not seeing recovery after many years or perhaps ever (these people still being followed).I think this condition is very, very difficult for young men, who may become preoccupied with suicide as a result. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors EMSAM is contraindicated in patients less than 12 years of age because of an increased risk of hypertensive crisis Table 1: Risk Differences of the Number of Cases of Suicidal Thoughts or Behaviors in the Pooled Placebo-Controlled Trials of Antidepressants in Pediatric and Adult PatientsDrug-Placebo Difference in Number of Patients of Suicidal Thoughts or Behaviors per 1000 Patients TreatedBlood Pressure Elevation Related to Concomitant Medication Adverse Reactions Leading To Discontinuation of TreatmentAdverse Reactions Occurring at an Incidence of 2% or More Among EMSAM-Treated PatientsTable 2.