Selegiline transdermal system: use pattern and adherence in patients with major depressive disorder

To discern the pattern of use of selegiline transdermal system as well as the level of adherence relative to other pharmacotherapies for treatment of major depressive disorder.

Deidentified patient-level data (2010-2011; N = 2,985) were abstracted from US longitudinal archives (Medicaid, Medicare, managed care) in this retrospective exploratory claims-based analysis. Major depressive disorder was defined as ICD-9-CM codes 292.2, 296.3, 300.4, or 311. Antidepressant treatment failure was defined as receipt of < 90 days of initial antidepressant.

Most patients received selegiline transdermal system as a second or third treatment option following treatment failure, and only 71 patients received it as first-line therapy. Patients were more likely to receive selegiline transdermal system for 60, 90, or 180 days compared to other therapies irrespective of treatment failure (P < .05). Among patients who did not fail treatment in the first 90 days, selegiline transdermal system was associated with a greater probability of receipt compared to selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors at 120 days (odds ratio [OR] = 1.21; 95% CI, 1.14-1.47) and 180 days (OR = 1.09; 95% CI, 1.01-1.28).

Although limited by the small sample size of patients receiving selegiline transdermal system versus other pharmacotherapies, the results suggest that after antidepressant treatment failure, earlier use of selegiline transdermal system may be warranted.