Can Emsam Patches Be Abused?
No, Emsam (selegiline transdermal system) has minimal to no abuse potential and is not classified as a controlled substance by the FDA. 1
Pharmacological Profile and Abuse Liability
The transdermal formulation of selegiline does not produce the pharmacological effects typically associated with drugs of abuse:
Metabolite production is minimized: While oral selegiline is metabolized to L-amphetamine and L-methamphetamine, the transdermal delivery system bypasses hepatic first-pass metabolism, substantially reducing the formation of these stimulant metabolites that could theoretically be sought for abuse 1, 2
Sustained, non-euphoric delivery: The transdermal system provides steady-state plasma concentrations without the rapid peaks associated with euphoria or reinforcing effects 3, 4
No stimulant classification: Unlike psychostimulants (methylphenidate, amphetamines) which are DEA Schedule II controlled substances due to abuse potential, selegiline transdermal system carries no such restrictions 5, 1
Clinical Context: Depression vs. Parkinson's Disease
The abuse potential remains negligible regardless of the underlying condition:
In major depressive disorder: Emsam is FDA-approved for MDD at doses of 6-12 mg/24 hours, with efficacy demonstrated in multiple controlled trials without reports of abuse-seeking behavior 6, 2, 4
In Parkinson's disease: Oral selegiline (not the transdermal formulation) is approved as adjunctive therapy for Parkinson's disease, and no abuse patterns have been documented even in this population requiring long-term treatment 1, 7
Important Caveats
Misuse concerns are related to safety, not abuse potential:
The primary risk with Emsam is dangerous drug interactions, not recreational misuse. Concomitant use with MAO inhibitors, tricyclic antidepressants, SSRIs, SNRIs, sympathomimetics, or meperidine can cause severe toxicity including hypertensive crisis and serotonin syndrome 1, 6
Dietary restrictions are not required at the 6 mg/24 hour dose but are recommended at higher doses (9-12 mg/24 hours) due to tyramine interaction risk 2, 3
Patients should be monitored for suicidal ideation and behavioral changes during initial treatment, as with all antidepressants, but this reflects depression-related risk rather than substance abuse 8
Practical point: Unlike stimulants used for ADHD which require careful monitoring for diversion and abuse 5, Emsam patches do not require such precautions and can be prescribed without concerns about recreational use or dependence.