Posted by Phillipa on January 11, 2010, at 20:15:53
I was amazed to just read my nursing letter and see the recommendation for Maois I'm astounded. I'm sure a lot of posters will rejoice!!!! Phillipa
From Reuters Health Information
MAOIs Are Underused in Atypical Depression: Study
NEW YORK (Reuters Health) Jan 08 - Some drugs are forgotten when they could still be useful, and monoamine oxidase inhibitors (MAOIs) could be among them. A large Canadian study has found that low prescription rates of irreversible MAOIs for atypical depression don't correlate with the agents' place in consensus guidelines and expert opinions."Without drug companies providing any promotion there is a risk that drugs like this will fall off the radar screen, and thereby patients are denied a potentially effective treatment for a very difficult condition," the study's lead author Kenneth I. Shulman, MD, of Sunnybrook Health Sciences Center in Toronto, told Reuters Health in an interview.
Dr. Shulman and his colleagues mined five government registries containing health care data on individuals 65 years of age and older. Overall, they were able to track the incidence and prevalence of phenelzine and tranylcypromine use in more than 1.4 million residents of Ontario between 1997 and 2007.
Both phenelzine and tranylcypromine are still recommended for treatment of refractory depression, atypical depression and bipolar disorder by the American Psychiatric Association and other groups.
According to the authors' report in the December Journal of Clinical Psychiatry, the incidence rate of MAOI prescriptions per 100,000 people dropped from 3.1 in 1997 to 1.4 in 2006. The prevalence rate per 100,000 decreased from 30.9 to 14.0. Over the entire study period, a total of 348 patients became new continuous users of irreversible MAOIs.
The researchers noted that if MAOIs were prescribed according to current consensus recommendations, prescription rates would be substantially higher. "The atypical depression subtype of mood disorder represents 1%-4% of the population and 15%-29% of all patients with major depressive disorder," they said.
Because MAOIs interact dangerously with certain other drugs, the investigators also analyzed concomitant prescriptions. They found that 63 patients (18.1%) were prescribed at least one serotonergic drug while taking an MAOI, which can cause serotonin syndrome. Fewer than six patients received a sympathomimetic drug concomitantly; such interactions can cause dangerous hypertensive crises.
"With appropriate dietary precautions these drugs are safe, and yet they are not being used," Dr. Shulman said. He added that it is the responsibility of senior clinicians and educators to ensure that younger physicians gain experience with MAOIs and use them appropriately in practice.
J Clin Psychiatry 2009;70:1681-1686.
poster:Phillipa
thread:933303
URL: http://www.dr-bob.org/babble/20100103/msgs/933303.html