MOCLOBEMIDE VERSUS CLOMIPRAMINE IN NONMELANCHOLIC, NONPSYCHOTIC MAJORDEPRESSION

The efficacy and the safety of moclobemide (400-600 mg/day), a reversi ble and selective inhibitor of monoamine oxidase-A (RIMA) and of clomi pramine (100-150 mg/day) were compared respectively in 98 and 93 nonme lancholic, nonpsychotic out-patients with a DSM-III major depressive e pisode over 6 weeks and up to 3 months, in a multi-center double-blind trial. No statistically significant difference between the treatments was found on the number of responders, at 6 weeks and 3 months, to th e Hamilton Depression Rating Scale (HDRS), which was the main criterio n for efficacy. The sample size was sufficient to detect a difference of approximatively 20%, in response rates. Reduction of the total scor es on HDRS and Covi anxiety scale was comparable for both treatments, but the reduction on the Retardation Depressive Scale (RDS) was signif icantly higher with moclobemide at the 1- and 2-week assessments. Acco rding to the RDS as well as the global impression of both patient and physician, a somewhat earlier onset of antidepressant action was evide nt in the moclobemide group. Tolerance was significantly better in the moclobemide group, mainly due to a lower frequency of weight gain, se dation and anticholinergic effects.