Seligiline transdermal system in depression

  • P.J. G
  • 16


    Mendeley users who have this article in their library.
  • 12


    Citations of this article.


Seligiline, a monoamine oxidase inhibitor, has been previously approved by the US FDA for adjunctive treatment of Parkinson's disease. At present, it has been found to be effective in a transdermal system when administered daily in the treatment of major depressive disorder. The minimum dosage of 6 mg/24 h was effective in two trials; this dosage did not require any dietary precautions. Higher doses of 9 mg/24 h and 12 mg/ 24 h may also not require restrictions, however, current data is insufficient. Furthermore, a randomized 52-week prevention study found significant benefits for continuance of this treatment. There are several types of safety data available. First, there have been no reports of hypertensive crisis in any patient receiving selegiline via this transdermal system at any of the three doses. Tyramine challenge studies have found a comfortable cushion of safety at selegiline doses of 6 mg/24 h. Other side effects include a slightly higher rate of orthostatic hypotension, insomnia and, most frequently, application site reactions. There are no significant effects on weight or sexual side effects. In terms of drug interactions, carbamazepine was found to significantly increase seligiline levels (however, carbamazepine should be contraindicated). Direct sympathomimetics may be safe, but indirect ones are thought to put the patient at risk. Finally, due to risk of serotonin syndrome, other medications contraindicated include: selective serotonin re-uptake inhibitors, serotonin-noradrenaline re-uptake inhibitors and multiple analgesics - in particular meperidine. To prevent toxic drug interactions at initiation of seligiline transdermal system therapy, all mediactions that are at risk should be completely stopped a minimum of 4 - 5 times their respective half-lifes for full elimination. This is generally a time period of 1 week. Upon stopping treatment with selegiline, 2 weeks should pass prior to beginning any medication at risk for drug interactions. (copyright) 2007 Informa UK Ltd.

Author-supplied keywords

  • Clinical Global Impression scale
  • Diagnostic and Statistical Manual of Mental Disord
  • Hamilton Depression Rating Scale
  • Parkinson disease
  • United States
  • analgesic agent
  • anorgasmia
  • application site reaction
  • area under the curve
  • article
  • blood pressure
  • buspirone
  • carbamazepine
  • cheese
  • clinical trial
  • cytochrome P450 2A6
  • cytochrome P450 2B6
  • cytochrome P450 2C9
  • cytochrome P450 3A
  • dextromethorphan
  • dextropropoxyphene
  • diarrhea
  • diphenhydramine
  • drug absorption
  • drug bioavailability
  • drug dose escalation
  • drug efficacy
  • drug elimination
  • drug half life
  • drug metabolism
  • drug safety
  • drug withdrawal
  • ejaculation
  • first pass effect
  • food drug interaction
  • human
  • hypertensive crisis
  • ibuprofen
  • impotence
  • insomnia
  • ketoconazole
  • libido
  • loading drug dose
  • long term care
  • maculopapular rash
  • major depression
  • meat
  • methadone
  • monotherapy
  • nonhuman
  • orthostatic hypotension
  • pain
  • paracetamol
  • pentazocine
  • pethidine
  • phenylephrine
  • phenylpropanolamine
  • placebo
  • pruritus
  • pseudoephedrine
  • psychotropic agent
  • selegiline
  • serotonin
  • serotonin noradrenalin reuptake inhibitor
  • serotonin uptake inhibitor
  • side effect
  • skin discoloration
  • systolic blood pressure
  • tramadol
  • tranylcypromine
  • tyramine
  • unindexed drug
  • unspecified side effect
  • vesicular rash
  • weight gain
  • weight reduction
  • wine
  • xerostomia

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Get full text


  • Goodnick P.J.

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free