Moclobemide in the treatment of major depressive disorder (DSM-3) following traumatic brain injury

Major depression (MDD) following traumatic brain injury (TBI) is a common p henomenon. There are no adequate studies in the literature defining optimum treatments for this condition following TBI. The opportunity arose to anal yse a group of patients who were included in a larger study of an antidepre ssant (moclobemide). As the treatment, but not the delivery, was known, thi s has the status of an open study. Twenty-six patients with major depressio n of late onset (mean 4.67 years post-TBI) were identified (18 male, 8 fema le), with a mean age at injury 28.49 years. The group was moderately depres sed with Hamilton Depression score (HAM-D) of 23.385 and moderately anxious with Hamilton Anxiety score (HAM-A) of 21.231. Mean HAM-D reduction was 81 % and HAM-A reduction 81%. Of the 26 subjects 23 were defined as responders . Onset of action was rapid, with 17 responding by day 3. Irritability scor es showed a mean reduction of 57% and pain scores a reduction of 39%. It is concluded that moclobemide may be an effective treatment for MDD following TBI, but properly controlled studies must be carried out to confirm this.