Now a patch that beats depression
APATCH that lets medicine seep through the skin into the bloodstream could be a new treatment for depression. About the same size as a nicotine patch, it contains a drug that has been shown to alter mood in patients with severe depression.
Sticking the patch anywhere on the upper body — usually on the trunk or arms — could be an alternative to the daily popping of pills for many people currently being treated for violent mood swings.
The patch, known as EMSAM, is currently going through the approval process by the U. S. Food and Drug Administration, although it’s not clear when it will become available in the UK.
It’s hoped the patch technology will improve control of mood swings by releasing a steady supply of medicine into the system.
This could do away with the peaks and troughs that occur when pills are swallowed and have to be absorbed through the gut into the bloodstream. Up to one in five people in Britain is affected by depression at some point in their lives and prescribing of anti- depressant pills on the NHS has reached record levels.
It can strike at any age and the feelings of hopelessness it triggers can make it difficult for people to hold down jobs or carry out normal daily activities.
Depression often runs in fami- lies, but the illness is normally associated with a chemical imbalance in the brain.
Over the past 20 years, a range of new drugs have emerged to treat the condition. Many doctors suspect the current ‘ epidemic’ of depression simply reflects the fact that more people are now being diagnosed.
Most of the new generation of drugs, such as Prozac, work by adjusting levels of a mood-altering chemical called serotonin.
These drugs can be extremely effective, but have been dogged in recent years by concerns that withdrawing treatment can trigger suicidal thoughts. The skin patch, being developed by Florida- based drug firm Somerset Pharmaceuticals, is aimed at patients with severe depression. It contains a drug called selegiline, which is already used to treat Parkinson’s disease but is also effective against depression.
Selegiline comes from a group of drugs known as monoamine oxidase inhibitors ( MAOIs). These are one of the oldest classes of anti- depressants and are usually used when other pills have not had any effect.
The drugs work by halting the
decline in brain chemicals called monoamines.
When depression sets
in, these chemicals get
broken down too quickly
by an enzyme called
monoamine oxidase.
The drugs stop this
destruction and allow
increased amounts of
chemicals to pump
round the brain.
But use of the drugs has been hampered by the fact that they can interact with certain foods, such as cheese, Marmite and red wine, that contain a compound called tyramine.
This can trigger a dangerous rise in blood pressure that has been known to cause a fatal brain haemorrhage.
However, selegiline is one of the safest drugs in the class and studies show that at low doses, the so- called ‘cheese effect’ does not occur.
The once-a- day skin patch will be available in different doses and at the lowest dose it should be safe to eat any foods.
It has already been tested on over 2,000 patients in the U. S. and the results suggest it can help some patients who do not respond to other drugs.
ONE STUDY carried out at the University of Pennsylvania looked at the effects on 365 patients aged between 18 and 65 with severe depression. Some of the patients were given active patches and the rest wore one with no medicine in it.
After eight weeks, researchers found a statistically significant improvement in mood and wellbeing among those wearing the real patch.
Professor David Nutt, an expert in psychiatric drugs at Bristol University, said: ‘ These kind of drugs do still have a role in the treatment of depression and are relatively underused due to somewhat unfounded safety fears.’
Dr Cosmo Hallstrom, a fellow of the Royal College of Psychiatrists, said a patch could potentially help some patients, but would probably be used only if other treatments failed.
‘ The problem with all antidepressants is people tend not to take them regularly,’ he said.
‘ Less than half those given a prescription by their doctor will actually take the tablets on a regular basis. This means they never have a chance to get the full benefit. So the convenience of a skin patch could really help to improve compliance.’