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Treatment History Characteristics Associated With Use of Isocarboxazid: A Nationwide Register-Based Study
Journal of Clinical Psychopharmacology
|January 24, 2022
Summary
Isocarboxazid (Marplan) is often prescribed for treatment-resistant depression, indicated by prior use of multiple antidepressant classes. This aligns with clinical guidelines for managing complex depression cases.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Epidemiology
Background:
- Isocarboxazid (Marplan), a monoamine oxidase inhibitor, has limited documented use in depression treatment.
- Understanding its clinical application is crucial for optimizing depression management.
Purpose of the Study:
- To investigate treatment history characteristics associated with the use of isocarboxazid in clinical practice.
- To identify patient profiles likely to receive isocarboxazid treatment.
Main Methods:
- Utilized nationwide Danish registers to identify adult incident users of isocarboxazid (2001-2018).
- Matched isocarboxazid users with controls on prescription date, age, sex, and region.
- Assessed 5-year treatment histories using multivariate conditional logistic regression.
Main Results:
- Identified 1455 isocarboxazid users and 7045 controls.
- Prior use of various antidepressant classes (SSRIs, SNRIs, TCAs), lithium, and antipsychotics significantly increased the likelihood of isocarboxazid use.
- Forty percent of isocarboxazid initiators had used drugs from 5+ psychopharmacological classes in the prior 5 years.
Conclusions:
- Isocarboxazid is predominantly used for treatment-resistant depression.
- Findings support current guideline recommendations for isocarboxazid's role in managing complex depression.
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