M. Justin Coffey

The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches

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.

Suicide in a health maintenance organization population

Author Contributions: Dr Hampton had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Hampton, Alexander, Budnitz. Acquisition, analysis, or interpretation of data: Hampton, Daubresse, Chang, Budnitz. Drafting of the manuscript: Hampton. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Hampton, Daubresse, Chang. Administrative, technical, or material support: All authors. Study supervision: Alexander, Budnitz.