MOCLOBEMIDE - A REVERSIBLE MAO-A-INHIBITOR SHOWING WEAKER ANTIDEPRESSANT EFFECT THAN CLOMIPRAMINE IN A CONTROLLED MULTICENTER STUDY

Antidepressant and unwanted effects of moclobemide (400 mg/day) and cl omipramine (150 mg/day) were compared in a double-blind, randomised, i n-patient, fixed-dose study with weekly ratings and drug level measure ments. After 1 week of single-blind placebo treatment, 115 patients wi th major depression fulfilled the criterion of a Hamilton Depression S cale (17-item, HDS) score of greater-than-or-equal-to 18 and were star ted on active treatment for 6 weeks. Drop-outs on moclobemide (n = 20) were in particular due to worsening and suicidality (n = 9) whereas d rop-outs on clomipramine (n = 12) in particular were due to side effec ts/adverse events (n = 6) and no drop-outs due to worsening. End-point analysis on the basis of different depression ratings showed consiste ntly a significantly weaker effect of moclobemide (final median HDS: 1 5) compared with clomipramine (final median HDS: 11). The difference i nvolved both sleep and depression symptoms. These results are generall y at variance with the main body of literature on moclobemide. althoug h a higher frequency of drop-out due to worsening in moclobemide-treat ed patients compared to tricyclic antidepressant-treated patients has been reported in several studies.