Interactions of moclobemide with concomitantly administered medication: evidence from pharmacological and clinical studies

Amrein, R.; Güntert, Theodor W.; Dingemanse, Jasper; Lorscheid, Thomas; Stabl, M.; Schmid-Burgk, W.

doi:10.1007/bf02246229

Cited by 55 publications

(21 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, studies have reported no adverse interactions with phenelzine, tranylcypromine (241), or moclobemide (242). There has been a case report (243) of the toxic serotonin syndrome (TSS), consisting of uncontrollable shivering, agitation, incoordination, restlessness in feet when sitting, involuntary contractions progressing to myocloniclike leg movements, hyperreflexia, and a frightened hyperarousal state believed to be secondary to the concomitant use of fluoxetine in a patient receiving CBZ for an affective disorder.…”

Section: Interactionsmentioning

confidence: 99%

Depression in Epilepsy: Etiology, Phenomenology, and Treatment

1999

View full text Add to dashboard Cite

Summary: A history of depression or depressive symptomatology has been reported in up to two-thirds of patients with medically intractable epilepsy, whereas community studies have demonstrated affective disorder only in a quarter of these patients. Depression has been reported peri-and interictally. However, differentiation may be difficult in patients with frequent seizures. Most authors have found no correlation between depression and epilepsy variables. However, complex partial seizures, especially of temporal lobe origin, appear to be etiologic factors, particularly in men with left-sided foci. Depression is also more common in patients treated with polytherapy especially with barbiturates, phenytoin, and vigabatrin. Depression has also been described de novo after temporal lobectomy. Psychosocial factors also play a part, but underlying risk factors (e.g., genetic, endocrine and metabolic) may explain the increased rates of depression in people with epilepsy compared to those with other neurologic and chronic medical conditions. The depression appears to be endogenous. Patients tend to exhibit fewer neurotic traits and more psychotic symptoms such as paranoia, delusions, and persecutory auditory hallucinations. Treatment approaches include psychotherapy, rationalization of antiepileptic drug medication, antidepressant treatment, and ECT. The tricyclic and related antidepressants appear to be epileptogenic, especially in people at high risk (personal or family history of seizures, abnormal pretreatment EEG, brain damage, alcohol or substance abuse/withdrawal and concurrent use of CNS-active medication). Seizures tend to occur early in treatment or after dose increments, especially if rapidly titrated. There is little evidence that the newer antidepressants, e.g., selective serotonin reuptake inhibitors, moclobemide, venlafaxine, or nefazodone are more epileptogenic than placebo.

show abstract

Section: Interactionsmentioning

confidence: 99%

Depression in Epilepsy: Etiology, Phenomenology, and Treatment

1999

View full text Add to dashboard Cite

show abstract

“…Morphine has never elicited the type I response but can elicit the type I1 response. Hence with moclobemide, an increased sensitivity or prolonged effect with morphine might theoretically be expected and some work in mice suggests a potentiation of effect [8]. In this case, the patient was taking a relatively large dose of drug (750 mg daily) but reaction to morphine was essentially normal considering the mode of administration and type of incision (Pfannensteil).…”

Section: Moclobemide and Anaesthesiamentioning

confidence: 87%

“…Mefenamic acid produced no obvious interaction in this patient. At therapeutic dosage (600 mg) moclobemide shows no clinically relevant interaction with digoxin, benzodiazepines, ibuprofen or neuroleptics [8].…”

Section: Moclobemide and Anaesthesiamentioning

confidence: 99%

“…Pethidine, which blocks neuronal re-uptake of serotonin, is the only commonly used narcotic that has elicited the excitatory response, and this response is potentially fatal. There is some evidence from animal work [8] that a similar reaction can occur with moclobemide, so that the use of pethidine is at present contraindicated. Presumably, in view of its metabolites, this also applies to phenoperidine, although there is no evidence to support or refute this.…”

Section: Moclobemide and Anaesthesiamentioning

confidence: 99%

See 1 more Smart Citation

Anaesthesia and the new generation monoamine oxidase inhibitors

McFarlane

1994

Anaesthesia

View full text Add to dashboard Cite

SummaryThe new generation nionoaniine oxidase inhibitors are short acting and specific for nionoaniine osidase A . Evidence to date aggests that there is little potential for significant interaction with niost drugs used in anaesthesia. Key wordsPharmacology; moclobemide, reversible inhibitors of monoamine oxidase A. Interactions.Historically, monoamine oxidase inhibitors (MAOIs) have been a bite noir for anaesthetists because of the potential for unpredictable and serious interactions with some drugs used in anaesthesia. A review in 1988 [ 1 ] clarified the nature of these interactions and the drugs to be avoided, but a general decline in usage of MAOIs despite their undoubted efficacy, means that anaesthetists are now only rarely confronted with the problem.Moclobemide (Manerix) is the first available member of a new generation of short acting MAOIs, that are specific for one type of receptor, the reversible inhibitors of monoamine oxidase type A (RIMAs) [2]. This new drug is virtually devoid of the serious side effects that are associated with first generation MAOIs, and is likely to become increasingly used for a wide spectrum of psychiatric illness [3]. The known pharmacological profile of this drug suggests that interaction with drugs used in anaesthesia jhould be minimal [4]. Case report.A woman of 38 years weighing 70 kg, with no important past medical history, presented with stress incontinence and, following investigation, was scheduled for operation to support her bladder neck outlet (colposuspension). She was physically fit and healthy but had suffered severe depression for more than 2 years. She had been maintained successfully on MAOIs and lithium but 8 months before surgery, her MA01 had been changed to moclobemide with good effect.She declined night sedation and on the morning of surgery moclobemide and lithium were omitted and temazepam 20 mg was given 2 h before operation. In the anaesthetic room she was relaxed but not drowsy. Anaesthesia was induced with propofol 160 mg to which lignocaine 10 mg had been added, followed by atracurium 35 mg. Anaesthesia was maintained with isoflurane in nitrous oxide and oxygen. and morphine 10 mg and droperidal 2.5 mg were given in divided doses during the operation. Blood pressure and heart rate remained stable (the highest pressure was 125,'80 and the lowest 90160) throughout the 50 min procedure. Muscle relaxation was reversed without incident and she awoke promptly.In the recovery room she received morphine 3 mg and was established on a morphine Patient Controlled Analgesia System (PCAS) to receive a 1 mg bolus dose with a 6 min lockout time. Over the next 32 h she received a total of 35 mg of morphine, remained comfortable and with stable blood pressure and heart rate. Moclobemide and lithium were restarted on the first postoperative day and analgesia was maintained over the next few days with oral mefenamic acid. Her stay in hospital was prolonged by 48 h because of an initial failure to retain bladder tone, for which she received ubretid.

show abstract

“…by a factor of 2 to 4 [8]. In a cross-over study, seven volunteers were studied before treatment with moclobemide, after a single 100 mg dose and after 100 mg three times a day for a week [9]. Phenylephrine was given by increasing infusion rates until systolic blood pressure increased by at least 30 mmHg.…”

Section: Discussionmentioning

confidence: 99%

Epidural anaesthesia, ephedrine and phenylephrine in a patient taking moclobemide, a new monoamine oxidase inhibitor

Martyr

Orlikowski

1996

Anaesthesia

View full text Add to dashboard Cite

SummaryWe report a case of low thoracic epidural and general anaesthesia in a patient receiving moclobemide, a new selective inhibitor ofmonoamine oxidase A . Intra-operative hypotension was initiaI1.v treated with phenylephrine and then with ephedrine. The short half-life of moclobemide and its modest interaction with direct and indirect acting sympathomimetic drugs permit the use of epidural anaesthesia, since any associated hypotension can be safely treated.

show abstract

Interactions of moclobemide with concomitantly administered medication: evidence from pharmacological and clinical studies

Cited by 55 publications

References 9 publications

Depression in Epilepsy: Etiology, Phenomenology, and Treatment

Depression in Epilepsy: Etiology, Phenomenology, and Treatment

Anaesthesia and the new generation monoamine oxidase inhibitors

Epidural anaesthesia, ephedrine and phenylephrine in a patient taking moclobemide, a new monoamine oxidase inhibitor

Contact Info

Product

Resources

About