Please See Important Safety Information, Including Boxed Warning, Below

Recognizing Treatment-Resistant Major Depression*

Treatment-Resistant Depression affects a significant percentage of patients suffering from Major Depressive Disorders

Major Depressive Disorder (MDD) is a recurring and chronic illness characterized by two or more major depressive episodes—each lasting at least two weeks and characterized by either depressed mood or loss of interest or pleasure in nearly all activities8. Once a patient has endured an episode of major depression, there is a 50%-60% risk of a second episode occurring. After a second episode there is a 70% chance of having a third; and in individuals who have had three episodes, there is a 90% chance of having a fourth. Each subsequent episode tends to be sooner and more abrupt and often presents with symptoms that are more severe9,10.

Relative Treatment-Responsiveness of Patients with Treatment-Resistant Depression (TRD)

Only about 20% of Depressed Patients may achieve minimally adequate symptom remission2. Some patients with Major Depression respond poorly to the more commonly prescribed SSRI or SNRI antidepressant drugs, and are thus deemed "Treatment-Resistant"9,10.

Treatment-Resistant Depression is thus defined as: Failure to respond to first line antidepressants.

Treatment of Depressed Patients that have been unresponsive to multiple antidepressant treatments has rarely been studied systematically. ECT has long been considered an option for treatment-resistant depression, but cognitive side effects, less than ideal duration of efficacy, high rates of relapse, and poor patient acceptability make this option problematic. Monoamine Oxidase Inhibitors (MAO Inhibitors), such as Marplan® (isocarboxazid) Tablets, my be another alternative for TRD3,4.

Review Marplan® (isocarboxazid) Tablets Clinical Trials and recent Meta-analyses.

Rediscover efficacy in Treatment-Resistant* Major Depression

Rediscover

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*Treatment failure with first-line antidepressants.

Please see Full Prescribing Information including BOXED WARNINGS regarding increased risk of suicidality in children and adolescents. MAO Inhibitors are contraindicated with certain drugs. Potential hypertensive crises may occur with foods that contain tyramine. As with all antidepressants, patients should be observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of treatment.

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of Marplan® (isocarboxazid) Tablets or any other antidepressant in a child, adolescent or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Marplan® (isocarboxazid) Tablets is not approved for use in pediatric patients. (See Warnings: Clinical Worsening and Suicide Risk, Precautions: Information for Patients, and Precautions: Pediatric Use).

Pooled analyses of short-term (4 to 16 weeks) placebo-controlled trials of 9 antidepressant drugs (SSRIs and others) in children and adolescents with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events in patients receiving antidepressants was 4%, twice the placebo risk of 2%. No suicides occurred in these trials.

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