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Re: Marplan » Elizabeth

Posted by Grouch on September 12, 2001, at 23:01:11

In reply to Re: Marplan » Grouch, posted by Elizabeth on September 12, 2001, at 3:21:08

> > Marplan was the MAO that really got off on the wrong foot. Several early studies showed it to be a less than spectacular antidepressant, so doctors shied away from it. However, it was later recognized that these studies were significantly flawed.
>
> I think the doses used were too small. Were there other flaws that you're aware of?

Yes, I think dose was one issue, but as I recall they were just generally poorly designed and poorly controlled studies. I read some of them a couple of years ago and I don't remember the specifics, but I can give you a few references if you'd like to look them up.

Kurland AA, Destounis N, Shaffer JW, et al: A critical study of isocarboxazide (Marplan) in the treatment of depressed patients. J Nerv Ment Dis 145:292-305, 1967

Rothman T, Grayson H, Ferguson J: An evaluation of the effectiveness of isocarboxazide (Marplan) in the depressive syndromes. Compr Psychiatry 2:27-34, 1961

Overall JE, Hollister LE, Pokorny AD, et al: Drug therapy in depressants. Controlled evaluation of imipramine, isocarboxazide, dextroamphetamine-amobarbital, and placebo. Clin Pharmacol Ther 3:16-22, 1962

Greenblatt MG, Grosser GH, Wechsler H: Differential response of hospitalized depressed patients to somatic therapy. Am J Psychiatry 120:935-943, 1964

Another article which acknowledges "methodologic problems" in these early studies (but doesn't go into specfics) and discusses some more recent better designed studies:

Zisook S. Side effects of isocarboxazid. J Clin Psychiatry. 1984 Jul;45(7 Pt 2):53-8.

> > There was also concern that Marplan might be toxic to the liver like its sister drug isoniazid (for TB), though time has shown this rarely to be a problem.
>
> Isoniazid is a hydrazide drug, like Marplan and Nardil, but isoniazid is not a MAO inhibitor to any significant degree. It is still used in the treatment of TB, although liver function testing is recommended. Iproniazid (Marsilid), another anti-TB drug, was the first MAOI used for depression and did get taken off the market due to hepatotoxicity.

Whoops. I was actually talking about iproniazid when I said isoniazid. The names are so easy to confuse. I suspect 'isocarboxazid' has probably caused some confusion as well, being so similarly named.


> > > Which came first: Trek ('66) or isocarboxazid? (I think Nardil and Parnate were first marketed in, respectively, '59 and '63.)
> >
> > There are Medline references to isocarboxazid as far back as '64 -- pre-Star-Trek era.
>
> OK, but which episode had the Marplan character?!!

I propose that Dr. Bob immediately set up a "Psycho-Star-Trek-Babble" board so that we may research and discuss this most important matter! :^)

> (BTW, Medline citations may predate the assignment of a brand name to a drug.)

Yeah.. I also did a search for "Marplan" and the oldest match was '66, so it probably still predates the Star Trek episode.

Grouch


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