Selegiline Transdermal System for the Treatment of Major Depression

of monoamine oxidase inhibitors (MAOIs) in the treatment of depression. This dopaminergic, noradrenergic, and serotonergic antidepressant class may be of particular value in the treatment of atypical depression, where it has demonstrated superior efficacy to tricyclics. Three MAOIs (isocarboxazid, phenelzine, and tranylcypromine) have long been approved in the United States for the treatment of depression. They irreversibly inhibit both forms of the monoamine oxidase enzyme: MAO-A and MAO-B. Their widespread use, however, has been limited by the need for strict dietary restrictions. In February 2006, the FDA approved the selegiline transdermal system (STS) (Emsam, Bristol-Myers Squibb) for the treatment of major depressive disorder (MDD). The agent, the first antidepressant patch, delivers selegiline transdermally and at the starting and potentially therapeutic dose of 6 mg/24 h can be used without dietary restrictions. This article will: • Describe the rationale for the development of STS;