SAMUEL GERSHON’S COMMENT ON ILDIKO MIKLYA’S REPLY TO ERVIN VARGA’S COMMENT ON MIKLYA’S ESSAY ON THE HISTORY OF SELEGILINE

I agree with Dr. Miklya that early clinical research with selegiline in psychiatry was done at a difficult time in Hungary. However I don’t think that the difficulties encountered in the introduction of deprenyl in the treatment of depression can be attributed entirely to those difficulties. In my Psychopharmacology Research Unit at New York University we also did open studies, like the Hungarian investigators with selegiline in the 1970s and we found that it had only a minimal effect in inpatient depression. Probably an even more important contributing factor was that the Hungarian investigators were not able to provide findings from double-blind controlled studies.  This alone would explain the little interest in the drug outside of Hungary. Finally, I think the most important contributing factor to the delay in the introduction of selegiline in the treatment of depression was the publicity of other antidepressants in the West, The intensity and the funding for advertising a new claimed therapeutic agent in the USA is colossal. Direct advertising of drugs in some countries still prohibited whereas in the USA it is   perfected to the extent that a patient with a particular set of depressive symptoms could ask their doctor to prescribe one or another antidepressant.

Samuel Gershon

December 11, 2014