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Dr. Bob is Robert Hsiung, MD,
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Posted by ZeeZee on January 19, 2003, at 10:02:11
Antidepressant by Patch May Cut Risky Side Effects
Reuters HealthBy Merritt McKinney
Monday, December 30, 2002
NEW YORK (Reuters Health) - An experimental skin patch may eliminate the need for dietary restrictions in people taking a certain type of antidepressant, according to a recent study.For some people with hard-to-treat depression, antidepressants called monoamine oxidase inhibitors (MAOIs) are the most effective treatment, but the drugs can have dangerous interactions with a long list of foods.
Now, researchers report that a skin patch containing the MAOI selegiline safely and effectively treats symptoms of depression. Because this was the first study to test an MAOI patch, participants avoided certain foods, but researchers believe that the patch will eliminate the need for a special diet.
For up to 20% of people with depressive and anxiety disorders, MAOIs are the most effective therapy, according to study co-author Dr. J. Alexander Bodkin.
"Despite this, only 1% of the antidepressant prescriptions in the US are for MAOIs," Bodkin, who is at McLean Hospital in Boston, Massachusetts, told Reuters Health. According to Bodkin, this is due "in large part" to the concerns that doctors and patients have about the drugs' interactions with certain foods.
MAOIs block enzymes involved in digesting substances called tyramines, which are fermented proteins found in a variety of foods, including cheeses and soy sauce. People taking MAOIs may experience the "cheese reaction"--a rapid rise in blood pressure that occurs if they eat foods containing tyramines.
Avoiding MAOIs "is keeping full recovery away for many, many people who are suffering more than they need to," Bodkin said.
A patch containing an MAOI "offers a very elegant way of avoiding the MAOI interaction," Bodkin said. He explained that the patch, by bypassing the gut, "leaves the enzymes in the gut relatively unaffected, while targeting the medication at the brain, where it is needed."
A patch containing the MAOI selegiline effectively relieved symptoms of depression in a short-term study, Bodkin and co-author Dr. Jay D. Amsterdam, of the University of Pennsylvania in Philadelphia, report in the November issue of the American Journal of Psychiatry.
In the 6-week study, 177 adults with major depressive disorder were randomly assigned to a daily selegiline patch or a placebo patch that did not contain any medication. Patients wearing the selegiline patch experienced significantly greater improvement in symptoms than those on the placebo. In addition, side effects were no more common in the treatment group than in the placebo group, with the exception of irritation at the site of the patch.
Since this was the first clinical trial to study an MAOI patch, participants abided by a diet that restricted tyramines. However, patients were given doses of tyramine to test their response. The dose required to trigger a response was much higher than consumed in a normal diet, so the authors conclude that dietary restrictions will be "unlikely" for an MOAI patch.
The patch is not yet available, but Bodkin said that, pending the approval of the US Food and Drug Administration, the patch could be on the market within a year.
Somerset Pharmaceuticals, Inc., in Tampa, Florida, provided some of the funding for the study.
SOURCE: American Journal of Psychiatry 2002;159:1869-1875.
Posted by wingedcat on January 20, 2003, at 6:31:28
In reply to MAOI patch revisited, posted by ZeeZee on January 19, 2003, at 10:02:11
Posted by Ritch on January 20, 2003, at 23:37:41
In reply to MAOI patch revisited, posted by ZeeZee on January 19, 2003, at 10:02:11
Transdermal delivery systems for the other MAOI's would be a great idea, too (phenelzine, tranylcypromine, and isocarboxazid). Since it is a different delivery method, companies could repatent it and make it available. Why not?
Posted by ZeeZee on January 21, 2003, at 17:55:59
In reply to Re: MAOI patch revisited » ZeeZee, posted by Ritch on January 20, 2003, at 23:37:41
This is the end of the thread.
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