Jonathan R Stevens1, M Justin Coffey2, Megan Fojtik3, Kristina Kurtz3, Theodore A Stern4. 1. Outpatient Services, Menninger Clinic, Houston, TX; Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Electronic address: jonstevens@menninger.edu. 2. Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; Neurostimulation and Clinical Informatics Menninger Clinic, Houston, TX. 3. Henry Ford Health System, Detroit, MI. 4. Psychiatric Consultation Service, Massachusetts General Hospital, Boston, MA; Psychosomatic Medicine/Consultation, Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Numerous currently available medications that act in the central nervous system can be delivered transdermally. Such medications include cholinesterase inhibitors for dementia, methylphenidate (MPH) for attention-deficit hyperactivity disorder, monoamine oxidase inhibitors (MAOIs) for depression, dopamine agonists for Parkinson disease and restless leg syndrome, and clonidine for attention-deficit hyperactivity disorder and impulse-control disorders. OBJECTIVE: This article aims to review the literature related to transdermal delivery systems from the perspective of clinical practice and research related to their use in the treatment of psychiatric conditions. RESULTS: Most of the currently available transdermal systems have psychotropic properties or utility in the behavioral health arena and, therefore, are of clinical relevance to consultation-liaison psychiatrists or practitioners of psychosomatic medicine. We discuss their efficacy and safety profiles. We provide a table of these agents and their uses. CONCLUSIONS: Transdermal delivery (i.e., patches) for medicines with psychotropic properties allows mental health providers to customize therapy for patients by altering the duration of therapy, minimizing first-pass metabolism and the potential for drug-drug interactions, and decreasing the risk for gastrointestinal irritation.
BACKGROUND: Numerous currently available medications that act in the central nervous system can be delivered transdermally. Such medications include cholinesterase inhibitors for dementia, methylphenidate (MPH) for attention-deficit hyperactivity disorder, monoamine oxidase inhibitors (MAOIs) for depression, dopamine agonists for Parkinson disease and restless leg syndrome, and clonidine for attention-deficit hyperactivity disorder and impulse-control disorders. OBJECTIVE: This article aims to review the literature related to transdermal delivery systems from the perspective of clinical practice and research related to their use in the treatment of psychiatric conditions. RESULTS: Most of the currently available transdermal systems have psychotropic properties or utility in the behavioral health arena and, therefore, are of clinical relevance to consultation-liaison psychiatrists or practitioners of psychosomatic medicine. We discuss their efficacy and safety profiles. We provide a table of these agents and their uses. CONCLUSIONS: Transdermal delivery (i.e., patches) for medicines with psychotropic properties allows mental health providers to customize therapy for patients by altering the duration of therapy, minimizing first-pass metabolism and the potential for drug-drug interactions, and decreasing the risk for gastrointestinal irritation.