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EMSAM (deprenyl patch): how a promising antidepressant was underutilized.

Gregory M Asnis1, Margaret A Henderson2

  • 1Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA ; Anxiety and Depression Clinic, Montefiore Medical Center, New York, NY, USA.

Neuropsychiatric Disease and Treatment
|October 23, 2014
PubMed
Summary

The EMSAM patch, a transdermal monoamine oxidase inhibitor (MAOI) antidepressant, is underutilized despite potential benefits for various depression types. Overstated side effect fears and limited research hinder its adoption, overlooking its advantages like minimal side effects and efficacy in anxious depression.

Keywords:
EMSAM patchMAOItyramine-free diet

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Neuroscience

Background:

  • The EMSAM patch is the only transdermal monoamine oxidase inhibitor (MAOI) antidepressant.
  • Clinicians anticipated better tolerability and efficacy compared to oral antidepressants.
  • Despite potential, EMSAM remains underutilized in clinical practice.

Purpose of the Study:

  • To explore reasons for the underutilization of the EMSAM patch.
  • To highlight the potential advantages of EMSAM that are often overlooked.
  • To encourage greater clinical interest and use of this unique antidepressant.

Main Methods:

  • Review of clinical use, side effect profiles, and existing literature on EMSAM.
  • Analysis of factors contributing to underutilization, including safety concerns and research gaps.
  • Identification and emphasis on the under-promoted benefits of transdermal MAOI therapy.

Main Results:

  • Underutilization is attributed to exaggerated fears of side effects (cheese reaction, serotonin syndrome) and lack of comprehensive studies.
  • Key advantages include avoidance of swallowing issues, minimal side effects, low risk of suicidal behavior, and efficacy in anxious and atypical depression.
  • The 6 mg/day dose does not necessitate dietary restrictions.

Conclusions:

  • Addressing exaggerated safety concerns and conducting further research can improve EMSAM's clinical adoption.
  • Highlighting EMSAM's unique benefits, such as its transdermal delivery and favorable side effect profile, is crucial.
  • Increased clinical awareness and research may unlock the full potential of EMSAM for treating diverse depressive conditions.