Moclobemide

What it is and how it works

Moclobemide selectively and reversibly inhibits MAO-A, increasing synaptic concentrations of noradrenaline, serotonin and dopamine. Because inhibition is reversible, the tyramine pressor response is much smaller than with irreversible MAOIs.

Indications

Major depression; social anxiety disorder (social phobia).

Dosage and administration (summary)

Oral, after meals: depression usually 300 mg daily in 2–3 divided doses, adjusted to 150–600 mg daily; social anxiety 300 mg daily initially, increased to 600 mg daily in two divided doses.

Contraindications

Acute confusional states, phaeochromocytoma, and concomitant use of selegiline or other MAOIs, linezolid, triptans, pethidine, tramadol, dextromethorphan or bupropion.

Warnings and precautions

Risk of serotonin syndrome with SSRIs, SNRIs, tricyclics and other serotonergic drugs; observe appropriate wash-out periods when switching. Very large amounts of tyramine-rich food should be avoided, and caution is needed in hepatic impairment and thyrotoxicosis. Monitor for suicidality and for mania in bipolar disorder.

Pregnancy

Data are limited; use only if the benefit outweighs the risk.

Storage and supply

Store below 25–30 °C.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.