What Is Emsam? Uses, Dosage, and What You Need to Know in 2026

Emsam is the brand name for the selegiline transdermal system — a skin patch that delivers the antidepressant medication selegiline through the skin directly into the bloodstream. It was FDA-approved on February 27, 2006, making it the first — and still only — transdermal antidepressant patch approved in the United States.

This guide covers everything patients and caregivers need to know about Emsam in 2026, including what it treats, how to use it, and important safety information.

What Is Emsam Used For?

Emsam is FDA-approved for the treatment of major depressive disorder (MDD) in adults. It is also approved for adolescents aged 12 and older.

It is typically prescribed when standard antidepressants have not worked or have been poorly tolerated. The American Psychiatric Association recommends MAOIs — the class Emsam belongs to — specifically for patients with atypical depression (which features mood reactivity, oversleeping, overeating, and intense sensitivity to rejection) and treatment-resistant depression.

Off-label uses that some providers consider include panic disorder and treatment-resistant anxiety disorders, though these are not FDA-approved indications.

What Drug Class Does Emsam Belong To?

Emsam is a monoamine oxidase inhibitor (MAOI). MAOIs were among the first antidepressants developed in the 1950s. They work by blocking the enzyme monoamine oxidase, which normally breaks down the neurotransmitters norepinephrine, dopamine, and serotonin. By inhibiting this enzyme, Emsam increases the availability of these mood-regulating brain chemicals.

What makes Emsam unique within the MAOI class is its transdermal delivery system, which bypasses the digestive tract and allows it to work effectively at lower doses without the strict dietary restrictions required by oral MAOIs at its starting dose.

What Are the Available Doses of Emsam?

Emsam comes in three strengths:

6 mg/24 hours (20 cm² patch, 20 mg total selegiline) — Starting and target dose; no dietary restrictions required

9 mg/24 hours (30 cm² patch, 30 mg total) — Requires low-tyramine diet

12 mg/24 hours (40 cm² patch, 40 mg total) — Maximum dose; requires low-tyramine diet

Dosing is done once daily. If a dose increase is needed, it's increased in 3 mg increments, and each increase requires at least 2 weeks at the current dose before increasing. The maximum dose is 12 mg/24hr.

How Do You Apply Emsam?

Apply the patch once every 24 hours. Follow these steps:

Choose a site: upper torso (between neck and waist, front or back), upper thigh, or outer upper arm

Make sure the skin is clean, dry, intact, and free of hair, lotion, or oils

Remove the patch from the sealed pouch, peel off the protective liner, and apply firmly to skin

Press and hold for 30 seconds

After 24 hours, remove the old patch, fold it sticky-side in, and safely discard

Apply the new patch to a different site (rotate sites each day; wait 2 weeks before reusing the same spot)

Wash hands thoroughly after handling

Is Emsam a Controlled Substance?

No. Emsam is not a controlled substance. It has no DEA schedule, meaning it does not require special prescribing authorization and can be prescribed by any licensed healthcare provider, including via telehealth. Refills can be authorized without the in-person visit requirements that apply to controlled substances.

Who Should NOT Use Emsam?

Emsam is contraindicated (should not be used) by patients who:

Are under 12 years of age

Have a pheochromocytoma (adrenal gland tumor)

Are currently taking SSRIs, SNRIs, TCAs, bupropion, mirtazapine, or other MAOIs

Are taking carbamazepine (can cause dangerous selegiline level increases)

Are taking certain opioids (meperidine, tramadol, methadone)

Is There a Generic Version of Emsam?

No. As of 2026, there is no FDA-approved generic for the Emsam patch. The drug is brand-only, manufactured by Viatris (formerly Mylan Specialty / Somerset Pharmaceuticals). A generic is not expected until approximately 2035, when current patent protections expire. This brand-only status contributes significantly to the medication's high retail cost of approximately $2,600–$2,800 per month.

How Does Emsam Compare to Other Antidepressants?

Unlike SSRIs and SNRIs, which work by preventing serotonin or norepinephrine reuptake, Emsam works by inhibiting the enzyme that breaks these neurotransmitters down. This distinction makes Emsam effective for some patients who haven't responded to reuptake inhibitors. For more on how Emsam works at the molecular level, see: How Does Emsam Work? Mechanism of Action Explained.

If you've been prescribed Emsam and need to find it at a pharmacy near you, medfinder can help. Enter your medication, dose, and ZIP code and medfinder will call pharmacies near you and text you back with results.