Transdermal Selegiline for Treatment-Resistant MDD

Dr. Harvinder Singh October 18, 2022

Psychiatry Education Forum Academy has released the next clinically relevant discussion today, where Dr. Harvinder Singh has discussed the role of Transdermal Selegiline for depression treatment.

Monoamine Oxidase Inhibitors (MAOIs) have not only shown efficacy with treatment resistant depression, but are also found efficacious for the treatment of depression in the elderly, panic disorder and phobias. The use of this effective antidepressant class has diminished due to the safety concerns, but MAOIs should not be ignored especially transdermal Selegiline (EMSAM). 

MAOIs are well known for the risk of causing cheese reaction, but do transdermal selegiline carries this risk?

Let’s begin by answering this hypothetical case:

Welcome to your Transdermal Selegiline

47 year old male with history of treatment resistant depression has failed trials of multiple antidepressants. He agreed for a trial of Transdermal Seligiline with 3 mg/24 hr dose, which was gradually titrated to 9 mg/24 hr dose. Which of the following symptoms are NOT commonly seen with Cheese Reaction?

Answer: Constricted Pupil

Here is one slide from this clinically relevant presentation:

This chapter will answer the following clinically relevant questions:

(1) Mechanism of Action: How is Transdermal Selegiline different from Oral Selegiline? 

(2) How to Dose & patch application instructions?

(3) Common Adverse Events with Transdermal Selegiline?

(4) What is Chesse Reaction with MAOIs?

(5) Can Transdermal Selegiline cause Cheese Reaction?

(6) Patient Instructions: Avoid this list of tyramine containing food.

(7) Drug Interactions: Medications to Avoid with Transdermal Selegiline?

(8) Medication Free Period: How long to wait before stopping or switching medications with transdermal selegiline?

TRANSDERMAL SELIGILINE FOR MDD

WATCH DISCUSSION

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