Indications & Usage
Marplan® (isocarboxazid) Tablets is indicated for the treatment of Major Depression. Because of its potentially serious side effects, Marplan® (isocarboxazid) Tablets is reserved for patients with Treatment-Resistant* conditions and should NOT be used as a first-line antidepressant for the treatment of newly diagnosed depression patients. All MAO Inhibitor products have the potential for causing hypertensive crisis when used with certain drugs or foods4.
The efficacy of Marplan® (isocarboxazid) Tablets in the treatment of Major Depression was established in 6-week controlled outpatient trials. Enrolled patients had symptoms that correspond to the American Psychiatric Association DSM-IV category of Major Depressive Disorder; however, they also had signs and symptoms of anxiety (anxious mood, panic, and/or phobic symptoms)4.
A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least two weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms3:
- Depressed mood
- Loss of interest in usual activities
- Significant change in weight and/or appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Increased fatigue
- Feelings of guilt or worthlessness
- Slowed thinking or impaired concentration
- Suicide attempt or suicidal ideation
The antidepressant effects of Marplan® (isocarboxazid) Tablets in hospitalized depressed patients, or in endogenomorphically retarded and delusionally depressed patients, has not been adequately studied.3
The effect of Marplan® (isocarboxazid) Tablets in long-term use (more than 6 weeks) has not been systematically evaluated in controlled trials. Therefore, the physician who elects to prescribe Marplan® (isocarboxazid) Tablets for extended periods should periodically evaluate the long-term usefulness of the drug for the individual patient.3
Rediscover efficacy in Treatment-Resistant* Major Depression
Please click on the menu column at the left to access product information, clinical data, and helpful patient support materials.
*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.