Monoamine oxidase inhibitor usage in Hawaii.

Objective: Previous studies involving prescriptions of monoamine oxidase inhibitors (MAOIs) have focused on predominantly Caucasian populations with little representation of Asian Americans and Pacific Islanders. The Asian American diet includes tyramine-rich fermented food items. This study describes the characteristics of MAOI prescribing patterns in Hawaii, a state with predominantly Asian Americans and Pacific Islanders.

Methods: Antidepressant usage including MAOIs were identified using a commercial insurance database from Hawaii Medical Service Association, a Blue Cross/Blue Shield subsidiary. Prescriptions from 1999 to 2003 were identified with basic information including ethnicity, age, diagnostic category, morbidity level, and 6 months adherence to MAOIs.

Results: Of the 28,890 patients prescribed antidepressants, seventeen individuals (0.06%, 95% confidence interval 0.03-0.09%) were prescribed MAOIs. MAOIs continue to be seldom used in treatment. There was no significant difference in prescriptions for MAOIs vs. other antidepressants based on ethnicity.

Conclusions: MAOIs are vastly underutilized in all ethnic groups including Asian American and Pacific Islander groups.