EFFICACY AND TOLERABILITY OF MOCLOBEMIDE IN COMPARISON WITH PLACEBO, TRICYCLIC ANTIDEPRESSANTS, AND SELECTIVE SEROTONIN REUPTAKE INHIBITORSIN ELDERLY DEPRESSED-PATIENTS - A CLINICAL OVERVIEW

Objective: To review the efficacy and safety of moclobemide in compari son with TCAs (for our purposes, ''TCAs'' will represent tricyclic and tetracyclic antidepressants, including maprotilin and mianserin) and selective serotonin reuptake inhibitors (SSRIs) in elderly depressed p atients. Methods: The efficacy data reviewed were obtained from the fo llowing sources: 1) results of published studies in the elderly; 2) da ta on patients aged greater than or equal to 60 years extracted from a ll available controlled trials in adults (greater than or equal to 18 years) in which moclobemide was compared with TCAs or SSRIs; and 3) th e adverse events were extracted for patients aged greater than or equa l to 60 years from the safety data base of all available comparative s hort-term studies with moclobemide versus TCAs, SSRIs, or placebo and of long-term studies with moclobemide. Results: The data show that moc lobemide is an effective antidepressant in depressed patients aged gre ater than or equal to 60 years. The response rare to moclobemide was 5 0% to 55% in this population. Moclobemide was more effective than plac ebo and was of similar efficacy to the TCAs and the more recently intr oduced SSRIs. The tolerability of moclobemide was rated as ''very good '' or ''good'' in almost 90% of these patients, which was better than the tolerability of TCAs and similar to that of SSRIs. Patients withou t any adverse events were more frequently found in the moclobemide gro up than in those treated with TCAs (P < 0.01) or SSRIs (P < 0.01). Adv erse events of the anticholinergic type were more frequent with TCAs t han with moclobemide (P < 0.001), and nausea was found 3 times more fr equently with SSRIs than with moclobemide (P < 0.01). Conclusions: Moc lobemide is an effective and well-tolerated antidepressant for the tre atment of elderly depressed patients.