Erratum to:  Moclobemide: An update of its pharmacological properties and therapeutic use

Fulton, Bret; Benfield, Paul

doi:10.1007/bf03259133

Cited by 26 publications

(40 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moclobemide is a reversible and selective inhibitor of monoamine oxidase (MAO) A and was found to be e¤ective in the treatment of depression (Silverstone 1993;Fulton and BenÞeld 1996). In addition to being e¤ective in depressive disorders, studies have shown moclobemide to be e¤ective in anxiety disorders (Versiani et al 1992(Versiani et al , 1997Nutt and Montgomery 1996).…”

Section: Introductionmentioning

confidence: 96%

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

et al. 1998

View full text Add to dashboard Cite

The objectives of this study were to assess the tolerability, safety, pharmacodynamics and pharmacokinetics of high-dose moclobemide in healthy subjects. Two sequential groups of six male and six female subjects (eight on active treatment, four on placebo) received for 8 days moclobemide 450 mg b.i.d. and 600 mg b.i.d., respectively. Intravenous tyramine pressor tests were conducted at baseline, at the beginning of treatment and at steady state. Oral tyramine pressor tests with 50, 100 and 150 mg tyramine were conducted under steady-state conditions. Pharmacokinetic parameters of moclobemide and two of its metabolites in plasma and urine were determined after the first and last dose of moclobemide. The incidence and intensity of adverse events was dose-dependent. The most frequently reported adverse events were insomnia, headache, dizziness and dry mouth. The i.v. tyramine pressor sensitivity during both moclobemide dosing regimens was enhanced 3 to 4-fold. Intake of tyramine 50 mg did not result in systolic blood pressure increases greater than 30 mmHg. With regard to blood pressure increases, tyramine 100 mg is still compatible with moclobemide 450 mg b.i.d. but not with 600 mg b.i.d. The clearance of moclobemide decreased by about 60% on multiple dosing, but no differences were found between both dosing regimens. The urinary excretion of the N-oxide metabolite doubled during multiple dosing. In conclusion, the maximum tolerated dose of moclobemide in healthy subjects is 600 mg b.i.d. provided the tyramine content in a meal is not higher than 50 mg.

show abstract

Section: Introductionmentioning

confidence: 96%

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Moclobemide has an elimination half-life of 1.6-2.1 h in healthy volunteers [2,33,36,39], which does not increase with age or renal impairment. The half-life is prolonged in patients with hepatic cirrhosis [33], and prolonged with multiple doses.…”

Section: Figurementioning

confidence: 97%

“…Moclobemide is a reversible and selective inhibitor of monoamine oxidase (MAO) type A [1,2]. Controlled clinical trials have demonstrated it to be effective in the treatment of depressive disorders.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity

Hackett

Dawson

Whyte

et al. 2003

Brit J Clinical Pharma

View full text Add to dashboard Cite

Aims To investigate the spectrum of toxicity of moclobemide overdose, the occurrence of serotonin toxicity, and to estimate toxicokinetic parameters. Methods All moclobemide overdoses presenting over a 10-year period to the Hunter Area Toxicology Service were reviewed. Clinical features, complications, length of stay (LOS) and intensive care (ICU) admission rate were extracted from a standardized, prospectively collected database. Comparisons were made between moclobemide alone and moclobemide with a serotonergic coingestant poisoning. Serotonin toxicity was defined by a combination of Sternbach's criteria and a clinical toxicologist's diagnosis. In five patients serial moclobemide concentrations were measured. Time to maximal plasma concentration ( T max ), peak plasma concentration ( C max ) and terminal elimination half-lives were estimated. Results Of 106 included patients, 33 ingested moclobemide alone, 21 ingested moclobemide with another serotonergic agent (in some cases in therapeutic doses) and 52 ingested moclobemide with a nonserotonergic agent. Eleven (55%) of 21 patients coingesting a serotonergic drug developed serotonin toxicity, which was significantly more than one (3%) of 33 moclobemide-alone overdoses (odds ratio 35, 95% confidence inteval 4, 307; P < 0.0001). In six of these 21 cases severe serotonin toxicity developed with temperature > 38.5 ∞ C and muscle rigidity requiring intubation and paralysis. The 21 patients had a significantly increased LOS (34 h) compared with moclobemide alone overdoses (12 h) ( P < 0.0001) and a significantly increased ICU admission rate of 57% vs. 3% ( P < 0.0001). Time to peak plasma concentration was delayed in two patients where prepeak samples were obtained. C max increased slightly with dose, but all three patients ingesting ≥ 6 g vomited or had charcoal. The mean elimination half-life of moclobemide in the five patients in whom serial moclobemide concentrations were measured was 6.3 h and elimination was first order in all cases. There was no evidence of a dose-dependent increase in half-life. Conclusions The effects of moclobemide alone in overdose are minor, even with massive ingestions. However, moclobemide overdose in combination with a serotonergic agent (even in normal therapeutic doses) can cause severe serotonin toxicity. The elimination half-life is prolonged by two to four times in overdose, compared with that found in healthy volunteers given therapeutic doses. This may be a result of wide interindividual variation in overall elimination, also seen with therapeutic doses, but appears not to be due to saturation of normal elimination pathways.

show abstract

“…Similarly, a meta-analysis of the clinical trials of moclobemide, a reversible inhibitor of monaoamine oxidase-A (RIMA) indicated that it, too was superior to TCAs in bipolar depression (7). RIMAs, unlike nonreversible inhibitors of monoamine oxidase such as tranylcypromine, are less likely to interact with monoamine containing food stuffs to produce a hypertensive reaction (8) and dietary restrictions are generally not required.…”

Section: Introductionmentioning

confidence: 99%

Moclobemide vs. imipramine in bipolar depression: a multicentre double‐blindclinical trial

Silverstone¹

2001

Acta Psychiatr Scand

View full text Add to dashboard Cite

Objective: To determine the relative ef®cacy, tolerability and risk of precipitating mania of moclobemide and imipramine in the treatment of bipolar depression. Method: A randomized, double-blind, parallel group, multicentre study of moclobemide (MCB) (450±750 mg daily) and imipramine (IMI) (150± 250 mg daily) in 21 centres in nine countries; 156 patients (65 males, 91 females) aged 18±65 with bipolar depression (17-item Hamilton Depression Rating Scale (HAMD) score ¢16) participated. Clinical status was assessed using standardized rating scales before treatment and at 1,2,3,4,6 and 8 weeks. The data were analysed on an intention to treat basis with the last observation carried forward. Results: In the MCB group, the mean HAMD fell from 23.0 to 13.1, in the IMI group it fell from 22.5 to 9.5; the mean score on the Montgomery±Asberg Depression Rating Scale (MADRS) fell from 29.5 to 16.3 on MCB and from 29.2 to 11.6 on IMI. There were no statistically signi®cant differences between the two groups on any ef®cacy measures. Anticholinergic side-effects were three times more common with IMI than MCB and weight gain was also greater on IMI. Two patients (3.7%) on MCB and six patients (11%) on IMI were withdrawn because of manic symptoms, with manic symptoms occurring earlier on IMI, although these differences did not reach statistical signi®cance. Conclusion: No differences in ef®cacy were detected between MCB and IMI in the treatment of bipolar depression. The data suggests that MCB is less likely than IMI to precipitate mania.Trevor Silverstone, on behalf of the Moclobemide Bipolar Study Group

show abstract

Erratum to: Moclobemide: An update of its pharmacological properties and therapeutic use

Abstract: The Editor regrets the omission.

Cited by 26 publications

References 0 publications

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity

Moclobemide vs. imipramine in bipolar depression: a multicentre double‐blindclinical trial

Contact Info

Product

Resources

About