Selegiline Transdermal System In the Treatment of Major Depressive Disorder

@article{Frampton2012SelegilineTS,
  title={Selegiline Transdermal System In the Treatment of Major Depressive Disorder},
  author={James E. Frampton and Greg L. Plosker},
  journal={Drugs},
  year={2012},
  volume={67},
  pages={257-265}
}
Abstract▴ The monamine oxidase (MAO) inhibitor selegiline is selective for MAO-B at the low oral dosages used in the treatment of Parkinson’s disease. However, MAO-A is also inhibited at the high oral dosages needed to effectively treat depression (not an approved indication), necessitating a tyramine-restricted diet. The selegiline transdermal system was designed to deliver antidepressant drug concentrations to the CNS, without substantially impairing small intestine MAO-A activity. At the… 
Selegiline Transdermal System: In the Treatment of Major Depressive Disorder
TLDR
Data from three randomized controlled trials showed a significantly better efficacy of STS in the treatment of unipolar major depression in comparison with placebo during 6–8 weeks of treatment, and one long-term randomized controlled trial demonstrated the efficacy of theSTS in relapse prevention of un bipolar depression over 1 year.
The pharmacokinetic evaluation of selegiline ODT for the treatment of Parkinson's disease
TLDR
The only well-justified advantage of the ODT formulation is its convenient use in parkinsonian patients who have difficulties in swallowing the regular formulation, and it suggests that the metabolites do not participate significantly in the therapeutic or toxic effects of selegiline.
Effects of combined treatment with clorgyline and selegiline on extracellular noradrenaline and serotonin levels
TLDR
Combined treatment using clorgyline and selegiline increased extracellular serotonin and noradrenaline levels more than each drug alone did, suggesting the augmented antidepressant action of the combination of MAO-A inhibition andMAO-B inhibition.
Interaction between Warfarin and Transdermal Selegiline: First Case Report and Literature Review
TLDR
Clinicians should be hypervigilant to this probable drug-drug interaction between warfarin and selegiline when initiating either therapy in a patient maintained on the opposing drug.
Original Article Interaction Between Warfarin and Transdermal Selegiline: First Case Report and Literature Review
TLDR
Clinicians should be hypervigilant to this probable drug-drug interaction between warfarin and selegiline when initiating either therapy in a patient maintained on the opposing drug.
Structure‐Based Specific Detection and Inhibition of Monoamine Oxidases and Their Applications in Central Nervous System Diseases
TLDR
In this review, progress in the detecting and inhibiting of MAOs and their applications in mechanism exploration and treatment of neurotransmitter‐related disorders is summarized.
Monoamine oxidase inhibitors and neuroprotection: a review.
TLDR
An overview of the neuroprotective/neurorescue properties of these multifaceted drugs is presented and focuses on phenelzine, (-)-deprenyl, rasagiline, ladostigil, tranylcypromine, moclobemide, and clorgyline and their possible neuroprot protective mechanisms.
Brain targeted delivery of mucoadhesive thermosensitive nasal gel of selegiline hydrochloride for treatment of Parkinson's disease
TLDR
A significant increase in brain dopamine, reduction in monoamine oxidase B level, increase in catalase activity and level of reduced glutathione upon treatment with SNT-gel indicated its effectiveness which was also supported by histopathology results, suggesting nasal thermosensitive gel holds better potential for brain targeting in Parkinson's disease over the conventional nasal or oral formulations.
Transdermal delivery of ethosomes as a novel vesicular carrier for paroxetine hydrochloride: In vitro evaluation and In vivo study
TLDR
The result indicates that the developed ethosomal system may be potential and safe to delivery paroxetine hydrochloride through transdermal delivery through transDermal delivery.
...
...

References

SHOWING 1-10 OF 27 REFERENCES
Transdermal Selegiline: The New Generation of Monoamine Oxidase Inhibitors
TLDR
Clinicians should familiarize themselves with the properties and indications for the new generation of MAOIs and it is possible that STS may demonstrate benefit in MDD with atypical features or MDD resistant to other antidepressants.
Selegiline transdermal system for the treatment of major depressive disorder: an 8-week, double-blind, placebo-controlled, flexible-dose titration trial.
TLDR
Results of this double-blind, placebo-controlled, dose titration trial provide evidence of short-term efficacy, safety, and tolerability of STS in the dose range of 6 mg/24 hours to 12 mg/ 24 hours for treatment of MDD.
A double-blind, placebo-controlled trial of the safety and efficacy of selegiline transdermal system without dietary restrictions in patients with major depressive disorder.
  • J. Amsterdam
  • Medicine, Psychology
    The Journal of clinical psychiatry
  • 2003
TLDR
Results from this double-blind, placebo-controlled clinical trial demonstrate that STS may have a modest, but statistically significant, antidepressant benefitCompared with placebo and a similar safety profile compared with placebo in the absence of a tyramine-restricted diet.
Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients.
TLDR
Transdermal selegiline (20 mg applied once daily by means of a 20-cm(2) patch) administered for 6 weeks was an effective and well-tolerated treatment for adult outpatients with major depression.
Monoamine oxidase inhibitors: a new generation.
Monoamine oxidase inhibitors (MAOIs), which ushered in the modern era of psychopharmacology in the 1950s, have remained useful in the treatment of depression despite important safety concerns, such
Daily transdermal administration of selegiline to guinea‐pigs preferentially inhibits monoamine oxidase activity in brain when compared with intestinal and hepatic tissues
TLDR
It is concluded that daily transdermal selegiline administration may provide therapeutic advantages over oral treatment, based on its preferential, dose‐dependent inhibition of brain vs peripheral MAO‐A activity.
Tyramine Pressor Sensitivity During Treatment With the Selegiline Transdermal System 6 mg/24 h in Healthy Subjects
TLDR
A wide tyramine safety margin is suggested for the selegiline transdermal system and evidence is provided that the 6‐mg/24‐h selegILine transDERmal system can be administered safely without dietary tyramines restrictions.
Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines
TLDR
The guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing, management when initial treatment fails, continuation treatment, maintenance treatment to prevent recurrence and stopping treatment.
Global burden of depressive disorders in the year 2000
TLDR
Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, covering almost 12% of all total years lived with disability worldwide.
...
...