My pdoc tried me on Emsam a few years back because finding an AD that didn't eventually stop working was becoming almost impossible. Emsam is a patch, and the good thing about it is that the dietary rules are not quite as restrictive as the other MAOI's. Still have restrictions, just not quite as long a list. I wasn't able to stay on it long enough to know if it was going to work though. It caused very sudden dips in my blood pressure and I kept passing out (not terribly convenient), so he had to pull be me off of it.