The Selegiline Transdermal Patch is a medication used to treat major depressive disorder in adults. It works by inhibiting monoamine oxidase (MAO), which helps increase levels of neurotransmitters like serotonin, dopamine, and norepinephrine in the brain. The patch is applied daily to intact skin on the upper arm, torso, or thighs, starting at a dose of 6 mg/24 hours. The dose can be increased by 3 mg every two weeks, up to a maximum of 12 mg/24 hours, depending on the patient's response. It is important to follow the prescribed dosing schedule carefully and avoid cutting the patch. Patients with certain conditions, such as bipolar disorder or heart problems, should use this medication with caution.
Key Points Explained:
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Mechanism of Action
- The Selegiline Transdermal Patch is an MAO inhibitor, which means it prevents the breakdown of neurotransmitters like serotonin, dopamine, and norepinephrine.
- By increasing these neurotransmitters, it helps regulate mood and alleviate symptoms of depression.
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Application and Dosage
- The patch is applied to clean, dry, intact skin on the upper arm, torso, or thighs.
- The initial dose is 6 mg/24 hours, with potential increases of 3 mg every two weeks, up to a maximum of 12 mg/24 hours.
- The patch should be replaced at the same time each day to maintain consistent drug levels.
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Important Usage Guidelines
- Do not cut the patch, as this can disrupt the controlled release of the medication.
- Rotate application sites to avoid skin irritation.
- Avoid exposing the patch to direct heat (e.g., heating pads, hot baths), as this may increase drug absorption unpredictably.
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Precautions and Contraindications
- Patients with bipolar disorder, heart conditions, or a history of mania/hypomania should use this medication cautiously.
- Those with pheochromocytoma (a rare adrenal gland tumor) should avoid it due to the risk of severe blood pressure spikes.
- Dietary restrictions (e.g., avoiding aged cheeses, cured meats) are typically required only at higher doses (above 6 mg/24 hours).
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Expected Effects and Monitoring
- Improvement in depressive symptoms may take 2–4 weeks or longer.
- Patients should be monitored for mood changes, blood pressure fluctuations, and potential side effects like dizziness or skin reactions.
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Comparison to Oral Selegiline
- The transdermal form provides more consistent drug levels than oral selegiline, which is primarily used for Parkinson’s disease at lower doses.
- It bypasses first-pass metabolism in the liver, reducing gastrointestinal side effects.
By following these guidelines, patients and healthcare providers can optimize the therapeutic benefits of the Selegiline Transdermal Patch while minimizing risks. Always consult a doctor before adjusting the dose or combining it with other medications.
Summary Table:
| Aspect | Details |
|---|---|
| Mechanism of Action | MAO inhibitor; boosts serotonin, dopamine, and norepinephrine levels. |
| Dosage | Start at 6 mg/24h, may increase by 3 mg every 2 weeks (max 12 mg/24h). |
| Application | Apply to clean, dry skin (upper arm, torso, thighs); rotate sites. |
| Key Precautions | Avoid cutting patches, heat exposure, and certain foods at higher doses. |
| Contraindications | Bipolar disorder, heart conditions, pheochromocytoma. |
| Expected Effects | Symptom improvement in 2–4 weeks; monitor mood and blood pressure. |
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