Moclobemide is the only representative of the group of reversible monoamine oxidase-A inhibitors (RIMA), and is the only antidepressant based on the inhibition of monoamine oxidase (MAO) in our country. It differs from older, so called irreversible MAO inhibitors through its selective action on the MAO-A isoenzyme, reducing its activity, which occurs only short term and has better safety profile regarding the risk of drug and food interactions.
At the level of intracellular signalization, moclobemide induces analogical changes as tricyclic antidepressants, SSRI and other antidepressants blocking monoamine reuptake. Efficacy and safety of moclobemide have been evaluated in a number of controlled studies including a total of 20 thousand patients treated mainly for depression as well as, to a lesser degree, for anxiety and neurotic disorders.
Available clinical studies confirm that the activity of moclobemide is higher than that of placebo, and its antidepressant potential is analogical to that of the main groups of antidepressants. Moclobemide has favourable adverse effect profile and its efficacy has been documented for all clinical subtypes of depression including dysthymia and double depression (dysthymia with depressive disorder).
It is suited for elderly patients with depression and moclobemide does not result in sexual dysfunction. It is effective in the therapy of social phobia.
The antidepressant effect of moclobemide is dose dependent and available clinical trials favour the use of higher doses