selegiline transdermal system

General information

• Class: Adjunctive therapy
• Common US brands: EMSAM
• Typical dose range: Apply one 6 mg/24 h patch to dry, intact skin daily; rotate sites on the upper torso, upper thigh, or upper arm and do not use the same site on consecutive days.
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2026-02-23

Dosing & forms

• Forms/strengths: Transdermal patches: 6 mg/24 h, 9 mg/24 h, 12 mg/24 h.
• Frequency: Apply one 6 mg/24 h patch to dry, intact skin daily; rotate sites on the upper torso, upper thigh, or upper arm and do not use the same site on consecutive days.
• Typical range: Apply one 6 mg/24 h patch to dry, intact skin daily; rotate sites on the upper torso, upper thigh, or upper arm and do not use the same site on consecutive days.

Mechanism (brief)

Selective MAO-B inhibitor at 6 mg/24 h; loses selectivity at higher doses providing MAO-A inhibition.

Metabolism & Half‑life

• Metabolism: CYP2B6, CYP2C19, CYP3A4
• Half‑life: Single-dose mean 25 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Blood pressure and heart rate at baseline, after dose increases, and periodically (watch for hypertensive crisis).
• Dermatologic inspection of application sites with each visit.
• Mood, suicidality, and emergent mania/hypomania symptoms throughout therapy.

Sources

• EMSAM (selegiline transdermal system) prescribing information — DailyMed (2024)
• Consensus recommendations for MAOI safety and dietary management — Journal of Clinical Psychopharmacology (2022)
• Monoamine oxidase inhibitors: Seriously underused in the treatment of major depression — Acta Psychiatrica Scandinavica (2024)
• APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)
• Selegiline transdermal system for the treatment of major depressive disorder: an 8-week, double-blind, placebo-controlled, flexible-dose titration trial — Journal of Clinical Psychiatry (2006)