MAOI Patch Finally on the Way

[Anasazi23]

Here's the link to the Psychiatric News Article.

We've been waiting for this for quite a while. Looks like it's getting closer - and possibly without dietary restriction warnings at low doses.

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[Poety]

I may be a safety hound - but I would still advise patients to avoid foods containing high amounts of tyramine. All I'd need is a crisis walking in the door after an advertisement saying "did you use the maoi patch? did you suffer from high blood pressure? Headaches? Stroke? If so call the law offices of Screw M. Docs for a free consulation"

 

[BKN]

I may be a safety hound - but I would still advise patients to avoid foods containing high amounts of tyramine. All I'd need is a crisis walking in the door after an advertisement saying "did you use the maoi patch? did you suffer from high blood pressure? Headaches? Stroke? If so call the law offices of Screw M. Docs for a free consulation"

Good for you. Generally a new drug is put on the market when the number of subjects who been exposed to it is in the low thousands. That will find common and occasional side effects but not the rare ones. Once we get into several million doses postmarketing the complete story becomes clear. I've watched a whole bunch of drugs come on the market as the answer, only to be removed within a couple of years for causing really bad things. I can remember when MAOIs were the only choice for depression. The side effects were occasionally not pretty at all. The tricyclics were probably worse but I'm hardly seeing SSRI adverse effects. Think carefully before you go for this drug. Those who can't remember the past are condemmed to repeat it. Blah-Blah-Blah.

 

[Poety]

yes and I'm really afraid of all these drugs that have just now been found to cause all these adverse affects i.e. skelaxin, vioxx, etc - how frightening is that? The problem with newer meds is that we can never tell what the long term effects are going to be.

When I was a nurse I used to say - oh its just your medicine, take it, its good for you - now as a doc I say - what are the consequences, what are the risks and benefits, how much do we really know - ugg, its like constant watch dogging!

Perhaps I shoulda stayed a nurse? naawww not as much fun

 

[Milo]

I don't know. MAOIs are still the most effective drug for atypical depression. I've got an outpatient that would likely do really well on this med, and quite likely at reduced risk compared to the oral MAOIs.

Automatically excluding a medication from one's armamentarium just because you don't want to be the first (or last) to prescribe it is very self protective but very sad.

Clearly explained risks and benefits and good informed consent should be enough to keep the lawyers at bay.

Zoloft starter packs just don't cut it for everyone.

 

[Poety]

I completely agree with you here Milo - I'm saying as in general - its scary to use new drugs when we don't know the long lasting effects - it just is. I realize this is part of medicine. But I've also been trained by docs that prefer to use more well known drugs and tend to shy away from things that are new on the market - I'm not saying its a bad idea - I'm saying I tend to err on the side of safety.

Further, I'm not implying at ALL that MAOI's are not a good choice of med (with this new form, they're saying they aren't going to add the warning to 20mg trandermal patch)- but in this day and age if you don't CYA - no one else will either!