Antidepressant medications are commonly prescribed to manage various mood disorders. Drug development continuously explores innovative methods for administering these treatments, aiming to enhance patient outcomes and improve the overall experience of medication use.
The Unique Antidepressant Patch
One innovation in antidepressant delivery is the transdermal patch. Selegiline, known by the brand name EMSAM, is the only antidepressant currently available in this form. It belongs to a class of drugs called monoamine oxidase inhibitors (MAOIs). The patch delivers the medication directly through the skin over a 24-hour period.
Advantages of Transdermal Delivery
Transdermal delivery offers several benefits. A primary advantage is bypassing first-pass metabolism in the liver. This process can degrade a significant portion of orally administered drugs before they reach systemic circulation. By avoiding this, more of the active medication can enter the bloodstream, potentially leading to more consistent drug levels.
This continuous, steady release of medication helps prevent peaks and troughs in drug concentration that can occur with pills. Maintaining stable drug levels may contribute to a more predictable therapeutic effect and potentially reduce certain systemic side effects. This delivery method also provides a non-invasive alternative, which can improve patient experience and adherence to treatment regimens.
How the Patch Works and Its Purpose
Selegiline functions as a monoamine oxidase (MAO) inhibitor. At lower doses, it selectively inhibits monoamine oxidase B (MAO-B), increasing dopamine and phenylethylamine levels in the brain. At higher doses, selegiline also inhibits monoamine oxidase A (MAO-A), further increasing serotonin, norepinephrine, and dopamine levels. By modulating these neurotransmitter levels, selegiline helps restore chemical balance in the brain. The selegiline patch treats major depressive disorder in adults.
Important Considerations for Use
Using the selegiline patch involves specific considerations, particularly regarding diet and potential drug interactions. At higher doses (9 mg/24 hours or 12 mg/24 hours), dietary restrictions are advised to avoid tyramine-rich foods, such as aged cheeses, fermented meats, and certain beers. This is because selegiline, as an MAOI, can inhibit the breakdown of tyramine, potentially leading to a sudden and severe increase in blood pressure. However, at the lowest dose of 6 mg/24 hours, these dietary restrictions are often not required.
Patients should also be aware of possible skin irritation at the application site, such as redness or itching. Various medications can interact with the selegiline patch, including other antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), certain pain medications, and cold or allergy remedies containing decongestants. Always discuss all current medications and supplements with a healthcare provider before starting the selegiline patch. They can provide guidance on proper use, monitor for side effects, and manage potential interactions.