The efficacy and safety of moclobemide compared to clomipramine in the treatment of panic disorder

The primary objectives of this multicenter study were to determine the effi cacy and safety of moclobemide, a selective reversible inhibitor of monoami no oxidase A, as drug treatment in DSM-III-R panic disorder with and withou t agoraphobia. In a comparative double-blind, randomized parallel-group des ign with fixed-flexible dose moclobemide 450 mg per day was compared to clo mipramine 150 mg per day, as that drug was considered standard treatment of panic disorder in Europe. 135 patients were randomized and treated for a p eriod of eight weeks. No other treatment was given. By the end of week 8, 4 9 % of the patients treated with moclobemide and 53 % of those treated with clomipramine were seen as treatment responders since they were without pan ic attacks. 78% of the patients in the moclobemide and 88% in the clomipram ine group were considered responders according to clinical global impressio n of change. No significant differences were found between the two treatmen ts at week 8. Adverse events were observed with significantly higher frequency among pati ents treated with clomipramine, particularly due to anticholinergic side ef fects. Close to 20% of those treated with moclobemide experienced headache, dizziness, nausea, insomnia, or dry mouth, but other adverse effects were infrequent. In conclusion, moclobemide in a dose of 450 mg per day seems to be a good d rug alternative for treatment of panic disorder with and without agoraphobi a.