A review of the literature on the selegiline transdermal system: an effective and well-tolerated monoamine oxidase inhibitor for the treatment of depression
by
Culpepper L, Kovalick LJ.
Department of Family Medicine,
Boston University Medical Center, Boston, Mass. ;
and Bristol-Myers Squibb, Princeton, N.J.
Prim Care Companion J Clin Psychiatry. 2008;10(1):25-30.

ABSTRACT

Objective: To provide a narrative review of the properties of the selegiline transdermal system (STS) for the treatment of depression and its subtypes.Background: Monoamine oxidase inhibitors (MAOIs) once represented the mainstay of therapy for the treatment of major depressive disorder (MDD). However, despite their efficacy, these agents fell from favor due to the risk of acute hypertensive reactions following ingestion of foods containing high concentrations of tyramine. Recent efforts to develop MAOIs that overcome these limitations have resulted in the introduction of the first transdermal formulation of the MAOI selegiline for the treatment of MDD.Data Sources: A PubMed literature search was conducted in January 2007 using the keyword selegiline transdermal system.Study Selection: Articles retrieved were reviewed and selected for inclusion based on their being randomized, double-blind, placebo-controlled studies that appeared between the years 2000 and 2007 and examined efficacy, safety, and tolerability data from clinical trials of patients with MDD who were treated with the STS. Four articles, including 3 acute trials and 1 long-term prevention of relapse trial, were included in this review based on these criteria.Conclusions: The selegiline transdermal system provides several advantages compared to orally administered MAOIs, including minimal interaction with dietary tyramine and prolonged exposure to the parent compound, while offering a favorable side effect profile. As a result, treatment at the lowest effective dose of 6 mg/24 hours can be administered without the need for dietary modifications.

Metabolism
High-dosage
Sexual effects
Antidepressant
Phenylethylamine
Antioxidant dosage
Atypical depressives
Long-term high-dosage
Selegiline plus phenylalanine
Selegiline and life-expectancy
Selegiline for longer-lived flies
EMSAM/antidepressant efficacy
Selegiline as an immunostimulant
Selegiline for cocaine-dependence
Selegiline and Parkinson's disease
Selegiline, NO and Alzheimer's disease
Antidepressant/dopamine D1 receptors
Transdermal selegiline as an antidepressant
Somerset's new transdermal selegiline patch

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