A clinician asks:  “Is there any data on the use of the Emsam patch in pregnancy?”

There is very little information on the reproductive safety of the MAOI-B inhibitor, selegiline, which is the active ingredient of the Emsam patch.  While animal studies have failed to reveal any evidence of teratogenicity, the medical literature includes only two cases of selegiline exposure during pregnancy.

As a class, MAOIs are typically avoided during pregnancy as the information on reproductive safety is sparse.  In addition, there have been concerns that MAOI inhibitors may interact with medications used during labor and delivery, including certain local and general anaesthetics.  This is less of a concern with the reversible MAOI-B inhibitors, but similar drug interactions may occur at higher doses of MAOI-B inhibitors.

Ruta Nonacs, MD PhD

Hagell P, Odin P, Vinge E. Pregnancy in Parkinson’s disease: a review of the literature and a case report. Mov Disord 1998;13:348.

Kupsch A, Oertel WH. Selegiline, pregnancy, and Parkinson’ disease. Mov Disord 1998;13:17594.