A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Marplan Pharmacology, Pharmacokinetics, Studies, Metabolism - Isocarboxazid
Marplan Pharmacology, Pharmacokinetics, Studies, Metabolism - Isocarboxazid
CLINICAL PHARMACOLOGY
Pharmacodynamics
Isocarboxazid is a non-selective hydrazine
monoamine oxidase
(MAO) inhibitor. In vivo and in vitro studies demonstrated
inhibition of MAO
in the brain, heart,
and liver. The mechanism
by which MAO inhibitors
act as antidepressants is not fully understood, but is thought to
involve the elevation of brain
levels of biogenic
amines. However, MAO is
a complex enzyme system, widely distributed throughout the body,
and drugs that inhibit MAO in the laboratory
are associated with a number
of clinical effects.
Thus, it is unknown whether MAO
inhibition per
se, other pharmacologic actions, or an interaction of both is responsible
for the antidepressant effects observed.
Pharmacokinetics Marplan pharmacokinetic information is
not available.
Clinical Efficacy Data
The effectiveness
of Marplan was demonstrated in two 6-week placebo-controlled studies
conducted in adult outpatients
with depressive symptoms that corresponded to the DSM-IV category
of major depressive disorder. The patients often also had signs
and symptoms of anxiety
(anxious mood, panic, and
or phobic symptoms). Patients were initiated with a dose
of 10 mg body
with increases every 2 to 4 days, as tolerated, until a therapeutic
effect was achieved,
up to a maximum dose
of 80 mg/ day. Doses were administered on a divided schedule ranging
from 2 to 4 times a day. The mean
dose overall for both studies
was approximately 40 mg/ day, with very few patients receiving doses
greater than 60 mg/ day. In
both studies at the end
of 6 weeks, patients receiving Marplan had significantly greater
reduction in signs
and symptoms of depression
evaluated by the Hamilton Depression Scale, for both the Total Score
and the Depressed Mood Score, than patients who received placebo.
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