title: A critical appraisal of the selegiline transdermal system for major depressive disorder.
abstract: The selegiline transdermal system (STS) is the first antidepressant transdermal medication approved by the US FDA for the treatment of major depressive disorder. Its unique antidepressant delivery system allows for steady release of selegiline over 24 h with minimal fluctuation in drug serum levels. It is able to deliver high enough central nervous system concentrations required for an antidepressant effect without substantially inhibiting Monoamine oxidase-A in the gastrointestinal and hepatic system, thereby reducing the risk of tyramine hypertensive crises especially at the lowest doses. Patient adherence theoretically could be improved due to ease of use and once-daily dosing when compared to oral counterparts' need for multiple daily doses. Clinical trials have established that doses between 6 and 12 mg over 24 h have been effective for major depressive disorder and tolerated among patients. Episodes of hypertensive crisis with STS have been minimally reported thus far. Overall, STS appears to be an effective agent for major depressive disorder when held to regulatory standards and post marketing analyses. This paper reviews the pharmacologic characteristics of STS and results of studies investigating its clinical efficacy and safety.
authors.affiliation: a 1 Department of Psychiatry, SUNY Upstate Medical Center , Syracuse, NY, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Bied
authors.affiliation: b 2 Department of Psychiatry & Behavioral Science, Emory University School of Medicine , Atlanta, Georgia.
authors.forename: Jungjin
authors.initials: J
authors.lastname: Kim
authors.affiliation: a 1 Department of Psychiatry, SUNY Upstate Medical Center , Syracuse, NY, USA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Schwartz
mesh_terms: D000279:Administration, Cutaneous; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy*; D065546:Drug Liberation; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D055118:Medication Adherence; D012642:Selegiline / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D057968:Transdermal Patch
chemical_list: D000928:Antidepressive Agents; D012642:Selegiline
keywords: MAO inhibitor; antidepressive agents; major depressive disorder; pharmacodynamics; pharmacokinetics; selegiline; transdermal system