Moclobemide: a reversible MAO-A-inhibitor showing weaker antidepressant effect than clomipramine in a controlled multicenter study. Danish University Antidepressant Group.
Antidepressant and unwanted effects of moclobemide (400 mg/day) and clomipramine (150 mg/day) were compared in a double-blind, randomised, in-patient, fixed-dose study with weekly ratings and drug level measurements. After 1 week of single-blind placebo treatment, 115 patients with major depression fulfilled the criterion of a Hamilton Depression Scale (17-item, HDS) score of > or = 18 and were started on active treatment for 6 weeks. Drop-outs on moclobemide (n = 20) were in particular due to worsening and suicidality (n = 9) whereas drop-outs on clomipramine (n = 12) in particular were due to side effects/adverse events (n = 6) and no drop-outs due to worsening. End-point analysis on the basis of different depression ratings showed consistently a significantly weaker effect of moclobemide (final median HDS: 15) compared with clomipramine (final median HDS: 11). The difference involved both sleep and depression symptoms. These results are generally at variance with the main body of literature on moclobemide, although a higher frequency of drop-out due to worsening in moclobemide-treated patients compared to tricyclic antidepressant-treated patients has been reported in several studies.
D000328:Adult; D000368:Aged; D001549:Benzamides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002997:Clomipramine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010555:Personality Inventory; D016037:Single-Blind Method
D001549:Benzamides; D008996:Monoamine Oxidase Inhibitors; D002997:Clomipramine; D020912:Moclobemide