The use of MAOIs in primary care.

Once a mainstay of antidepressant treatment, monoamine oxidase inhibitors (MAOIs) have largely been abandoned in favor of medications with improved safety profiles. However, remission rates for patients with depression remain low, and primary care physicians continue to have patients who either do not respond or only partially respond to newer medications. MAOIs have proven efficacy for depression, particularly for patients with atypical depression, high levels of anxiety, anergic bipolar depression, and treatment-resistant depression. A transdermal delivery system has been developed for an MAOI that avoids the need for patients to follow dietary restrictions and has fewer metabolic and sexual side effects than some newer medications, which may make it particularly suited for use in primary care.