Moclobemide and specific serotonin re‐uptake inhibitor combination treatment of resistant anxiety and depressive disorders

Bakish, David; Hooper, Cynthia; West, D. L.; Miller, Carlos O.; Blanchard, Anne; Bashir, Farah

doi:10.1002/hup.470100205

Cited by 19 publications

(9 citation statements)

References 18 publications

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“…Several trials have evaluated moclobemide alone or in combination with TCAs or SSRIs in the treatment of refractory depression [69] reporting positive results. These data are limited and great caution is necessary because of the potential to induce the serotonin syndrome when combining moclobemide with serotonergic drugs.…”

Section: Depressive Disordersmentioning

confidence: 97%

Clinical Applications of MAO-Inhibitors

Riederer

Lachenmayer²,

Laux³

2004

Current Medicinal Chemistry

205

115

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Monoamine oxidase inhibitors (MAO-I) have been useful in the treatment of both psychiatric and neurological disorders over centuries. Here we focus on the development of this drug treatment. Focus is given on the use of irreversible MAO-I's as well as on reversible ones. Benefit and side effects are reported for Parkinson's disease, Alzheimer's dementia, depression syndrome and panic disorders. The preclinical and clinical effects of selegiline with regard to neuroprotection are highlightened and the conclusion is drawn that there is good evidence for a clinical neuroprotective capacity based on the assumption that the 50 percent recovery of MAO-B is obtained already after a 10 days withdrawal of selegiline. There is also a focus on selegilines metabolism to amphetamine and metamphetamine. In order to avoid any such effects of metabolic compounds on the cardiovascular system Zydis Selegiline, a melt-tablet avoid of major metabolism to amphetamine and metamphetamine is described in detail. Developments in MAO-I research are discussed in detail as there are moclobemide, lacabemide, rasagiline. Interactions of MAO-I' with tricyclics and serotonin selective reuptake inhibitors (SSRI's) are described as there is mentioning of interactions of MAO-I's with other compounds in general. Tables and figures report on clinical studies and on pharmacological properties of MAO-I's.

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Section: Depressive Disordersmentioning

confidence: 97%

Clinical Applications of MAO-Inhibitors

Riederer

Lachenmayer²,

Laux³

2004

Current Medicinal Chemistry

205

115

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“…Included studies were published between 1986 and 2018. They consisted of eight narrative reviews (Bakker, Van Balkom, & Stein, 2005;Bandelow et al, 2008;Bystritsky, 2006;Chen & Tsai, 2016;Holt & Lydiard, 2007;Lorenz, Jackson, & Saitz, 2010;Pollack, 2009;Starcevic, 2008), five systematic reviews (Barton et al, 2014;Cosci & Fava, 2013;Ipser et al, 2006;Patterson & Van Ameringen, 2016;Samuel, Zimovetz, Gabriel, & Beard, 2011), of which three also performed meta-analyses (Barton et al, 2014;Ipser et al, 2006;Patterson & Van Ameringen, 2016), seven treatment guidelines/ algorithms (Bandelow, 2008 (Gabriel & Violato, 2011;Gabriel, 2010;George et al, 2008;Glue et al, 2017Glue et al, , 2018Heldt et al, 2003;Heldt et al, 2006;Hoge et al, 2008 Gloster et al, 2015;Hirschmann et al, 2000;Lohoff et al, 2010;Pollack et al, 2006;Rickels et al, 2012;Simon et al, 2009), four retrospective cohorts (Bakish et al, 1995;Cowley, Ha, & Roy-Byrne, 1997;Durham, Higgins, Chambers, Swan, & Dow, 2012;, one prospective cohort (Milrod et al, 2016), three case series (Aarre, 2003;Otto, Pollack, Penava, & Zucker, 1999;Tesar & Rosenbaum, 1...…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review

et al. 2019

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Anxiety Disorders often show a chronic course, even when treated with one of the various effective treatments available. Lack of treatment effect could be due to Treatment Resistance (TR). Consensus on a definition for TR Anxiety Disorders (TR‐AD) is highly needed as currently many different operationalizations are in use. Therefore, generalizability in current TR‐AD research is suboptimal, hampering improvement of clinical care. The objective of this review is to evaluate the currently used definitions of TR‐AD by performing a systematic review of available literature. Out of a total of n = 13 042, 62 studies that operationalized TR‐AD were included. The current review confirms a lack of consensus on TR‐AD criteria. In 62.9% of the definitions, TR was deemed present after the first treatment failure. Most studies (93.0%) required pharmacological treatment failures, whereas few (29.0%) required psychological treatment failures. However, criteria for what constitutes “treatment failure” were not provided in the majority of studies (58.1%). Definitions for minimal treatment duration ranged from at least 4 weeks to at least 6 months. Almost half of the TR‐AD definitions (46.8%) required elevated anxiety severity levels in TR‐AD. After synthesis of the results, the consensus definition considers TR‐AD present after both at least one first‐line pharmacological and one psychological treatment failure, provided for an adequate duration (at least 8 weeks) with anxiety severity remaining above a specified threshold. This definition could contribute to improving course prediction and identifying more targeted treatment options for the highly burdened subgroup of TR‐AD patients.

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“…Monoamine oxidase inhibitors (MAOIs) are effective for both PD and SAD and are thought by some experts to be excellent options for severe, treatment-resistant anxiety disorders (e.g., Bakish et al, 1995). However, they have the worst side effect profile and greatest safety burden of all antidepressants.…”

Section: Pharmacotherapy For Anxiety Disorders:current Statusmentioning

confidence: 99%

Pharmacological treatment of anxiety disorders: Current treatments and future directions

Farach

Pruitt

Jun

et al. 2012

Journal of Anxiety Disorders

146

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Modern pharmacological treatments for anxiety disorders are safer and more tolerable than they were 30 years ago. Unfortunately, treatment efficacy and duration have not improved in most cases despite a greater understanding of the pathophysiology of anxiety. Moreover, innovative treatments have not reached the market despite billions of research dollars invested in drug development. In reviewing the literature on current treatments, we argue that evidence-based practice would benefit from better research on the causes of incomplete treatment response as well as the comparative efficacy of drug combinations and sequencing. We also survey two broad approaches to the development of innovative anxiety treatments: the continued development of drugs based on specific neuroreceptors and the pharmacological manipulation of fear-related memory. We highlight directions for future research, as neither of these approaches is ready for routine clinical use.

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Moclobemide and specific serotonin re‐uptake inhibitor combination treatment of resistant anxiety and depressive disorders

Cited by 19 publications

References 18 publications

Clinical Applications of MAO-Inhibitors

Clinical Applications of MAO-Inhibitors

Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review

Pharmacological treatment of anxiety disorders: Current treatments and future directions

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