Monoamine oxidase inhibitor usage in Hawaii

Previous studies involving prescriptions of monoamine oxidase inhibitors (MAOIs) have focused on predominantly Caucasian populations with little representation of Asian Americans and Pacific Islanders. The Asian American diet includes tyramine-rich fermented food items. This study describes the characteristics of MAOI prescribing patterns in Hawaii, a state with predominantly Asian Americans and Pacific Islanders.

Antidepressant usage including MAOIs were identified using a commercial insurance database from Hawaii Medical Service Association, a Blue Cross/Blue Shield subsidiary. Prescriptions from 1999 to 2003 were identified with basic information including ethnicity, age, diagnostic category, morbidity level, and 6 months adherence to MAOIs.

Of the 28,890 patients prescribed antidepressants, seventeen individuals (0.06%, 95% confidence interval 0.03-0.09%) were prescribed MAOIs. MAOIs continue to be seldom used in treatment. There was no significant difference in prescriptions for MAOIs vs. other antidepressants based on ethnicity.

MAOIs are vastly underutilized in all ethnic groups including Asian American and Pacific Islander groups.