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Marplan® (isocarboxazid) is indicated for the treatment of depression. Because of its potentially serious side effects, Marplan is not an antidepressant of first choice in the treatment of newly diagnosed depressed patients. All MAO-I products, have the potential for causing hypertensive crisis when used with certain drugs or foods.
The efficacy of Marplan in the treatment of depression was established in 6-week controlled trials of depressed outpatients. These
patients had symptoms that corresponded to the DSM-IV category of major depressive disorder; however, they often also had signs
and symptoms of anxiety (anxious mood, panic, and/or phobic symptoms).
A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed
or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: 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, and a suicide attempt or suicidal ideation.
The antidepressant effects of Marplan in hospitalized depressed patients, or in endogenomorphically retarded and delusionally
depressed patients, has not been adequately studied.
The effect of Marplan in long-term use, that is, for more than 6 weeks, has not been systematically evaluated in controlled
trials. Therefore, the physician who elects to use Marplan for extended periods should periodically evaluate the long-term usefulness
of the drug for the individual patient.
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.
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