Introduced decades ago as the next step in antidepression pills, monoamine oxidase inhibitors (MAOIs) soon fell out of favor. Extremely effective in some people, they caused potentially lethal blood pressure spikes in others because of interactions with food in the gut. That and the subsequent rise of selective serotonin reuptake inhibitors (SSRIs) put them on a shelf. But a new skin patch has resurrected the drugs from obscurity.
The patch, Emsam, developed by Somerset Pharmaceuticals and marketed by Bristol-Myers Squibb, delivers an MAOI, selegiline, directly and continuously into the bloodstream, eliminating exposure to the gut and maximizing its effect in the brain. “This is big news for long-term patient benefit,” says Alexander Bodkin, chief of clinical psychopharmacology research at Harvard University’s McLean Hospital, who was part of the research team. “Now those who have been untreatable could be safely treated.”