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Are the monamine oxidase inhibitors facing extinction?
1St. Thomas Psychiatric Hospital, Ontario.
Summary
Monoamine oxidase inhibitor (MAOI) prescriptions declined significantly in Saskatchewan between 1978 and 1986, with physicians increasingly avoiding these antidepressants, especially for elderly patients.
Area of Science:
- Pharmacology
- Psychiatry
- Health Services Research
Background:
- Monoamine oxidase inhibitors (MAOIs) are a class of antidepressants.
- Changes in antidepressant prescribing patterns are of clinical interest.
Purpose of the Study:
- To compare the utilization of monoamine oxidase inhibitors (MAOIs) in Saskatchewan between 1978 and 1986.
- To identify trends in MAOI prescribing practices.
Main Methods:
- Utilized the Saskatchewan Prescription Drug Plan database for data extraction.
- Compared prescription data for adult populations in 1978 and 1986.
Main Results:
- MAOI use decreased from 0.17% in 1978 to 0.07% in 1986.
- Tricyclic and new-generation antidepressant use increased during the study period.
- Physicians, particularly non-psychiatrists, showed reduced MAOI prescribing, with notable avoidance in the elderly population.
Conclusions:
- Physician reluctance to prescribe MAOIs increased despite evidence supporting their safety and efficacy.
- Prescribing patterns shifted away from MAOIs towards other antidepressant classes.
- The findings highlight a divergence between clinical literature and prescribing practices for MAOIs.