This week’s Pearl of the Week dives into one of psychiatry’s most overlooked breakthroughs: the only transdermal antidepressant the FDA has ever approved. Why did this one medication earn a category all its own? What makes its delivery system different? And how did it manage to bypass the infamous tyramine diet—but only at one very specific dose?

In this episode, we explore the surprising science behind a patch that quietly changed how MAOIs can be used in modern practice. From the oddball FDA studies (including research volunteers eating pounds of cheese in a lab) to the elegant pharmacology that lets the patch boost dopamine in the brain without shutting off tyramine protection in the gut, this pearl reveals why clinicians often underestimate one of the most unique antidepressants we have.

If you’ve ever wondered how MAO-A and MAO-B actually work, why dose determines dietary safety, or what makes transdermal delivery so different from pills, this is the story you haven’t heard. Clear, simple, and clinically sharp—perfect for psych NPs, students, and anyone who loves uncovering the “how” and “why” behind the medications we prescribe.

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Pearl of the Week: What Is the Only Transdermal Antidepressant?

Pearls and Prep

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