Efficacy and Tolerability of Moclobemide Compared with Imipramine in Depressive Disorder (DSM-III): An Austrian Double-blind, Multicentre Study∗

Baumhackl, Ulf; Biziere, Kathleen; Fischbach, Roman; Geretsegger, Ch.; Hebenstreit, G.; Radmayr, E; Stabl, M.

doi:10.1192/s0007125000297535

Cited by 99 publications

(49 citation statements)

References 6 publications

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“…Unfortunately, moclobemide although successfully used in Europe was never registered for the US market. Data from clinical studies (Stabl, Biziére, Schmid-Burgk, & Amrein, 1989;Baumhackl et al, 1989;Versiani et al, 1989;Kok & Tsoi, 1995;Rimón et al, 1993;Silverstone et al, 1994) suggested that moclobemide treatment was superior to placebo and comparable, as judged by an improvement of the HAM-D rating score, to imipramine, a tricyclic antidepressant, in studies treating patients suffering from major depressive disorders. The doses applied ranged from 75 mg/d to 600 mg/d and the response rates reported from 50% to 70%.…”

Section: Depressionmentioning

confidence: 99%

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Entzeroth¹,

Ratty²

2017

OJD

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Over more than 60 years, monoamine oxidase (MAO) inhibitors are available for therapy of central nervous diseases. Although they have shown to be efficacious specifically in the treatment of major depressive disorders and treatment-resistant depression, they became less a therapeutic choice for the physicians mostly due to severe side effects, such as liver failure and hypertensive crisis associated specifically with the first generation of inhibitors. Nevertheless, this class of drugs is still being used for treatment specifically as more selective and reversible inhibitors became available and will provide clinicians with additional treatment options. The current review revisits monoamine oxidase inhibitors and their potential in the treatment of human diseases, such as anxiety, depression, mood and personality disorders, and pain and introduces current ideas and developments.

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Section: Depressionmentioning

confidence: 99%

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Entzeroth¹,

Ratty²

2017

OJD

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“…Vallejo et al (1987) 139 Imipramine, phenelzine Phenelzine Ͼ imipramine Baumhackl et al (1989) 140,b Moclobemide, imipramine Moclobemide = imipramine Ravindran et al (1994) 158 Fluoxetine 65% response Marin et al (1994) 135,a Desipramine 70% response 159,a Desipramine 61% response Kocsis et al (1996) 160,a Desipramine 71% response Dunner et al (1996) 23 Fluoxetine Fluoxetine = CBT Dunner et al (1997) 150 Venlafaxine Ͼ70% response Keller et al (1998) 132,c Sertraline, imipramine Sertraline = imipramine Santagostino et al (1998) 161 Alprazolam 73% response Smeraldi (1998) 162 Amisulpride, fluoxetine Amisulpride = fluoxetine Ravindran et al (1998) 151 Venlafaxine Kocsis et al 166 indicated that the higher relapse rate in those dysthymic patients who were randomized to placebo exceeded that of patients who continued on the maintenance desipramine treatment. Paralleling these findings, symptom improvement was sustained, and the rate of relapse reduced, among dysthymic patients who were maintained on either trazodone or fluoxetine over a 40-week interval compared to those who discontinued medication.…”

Section: Non-placebo-controlledmentioning

confidence: 99%

“…Moreover, it has been suggested that optimal drug effects would be obtained when administered primarily to patients with subaffective, rather than character spectrum disorder. 4 In fact, studies which employed rigorous diagnostic criteria, established the efficacy of tricyclic agents, such as imipramine and desipramine, [131][132][133][134][135][136][137] MAOIs, 136,138,139 the reversible monoamine oxidase inhibitor, moclobemide, 114,137,[140][141][142][143] SSRIs, such as fluoxetine and sertraline, 22,23,111,132,134,[144][145][146] as well as other agents, such Molecular Psychiatry as the 5HT 2 antagonist, ritanserin, 147,148 the selective norepinephrine reuptake inhibitor, reboxetine, 149 and the serotonin/norepinephrine reuptake inhibitor (SNRI), venlafaxine 150,151 (Table 1). The use of well tolerated compounds, including moclobemide and sertraline, may be effective in the long-term management of dysthymia.…”

Section: Pharmacological Contributions To the Analysis Of Dysthymiamentioning

confidence: 99%

Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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Although dysthymia, a chronic, low-grade form of depression, has a morbidity rate as high as that of major depression, and increases the risk for major depressive disorder, limited information is available concerning the etiology of this illness. In the present report we review literature concerning the biological and characterological features of dysthymia, the effectiveness of antidepressant treatments, the influence of stressors in the precipitation and maintenance of the disorder, and both quality of life and psychosocial correlates of the illness. We also provisionally suggest that dysthymia may stem from disturbances of neuroendocrine and neurotransmitter functioning (eg, corticotropin releasing hormone and arginine vasopressin within the hypothalamus, or alternatively monoamine variations within several extrahypothalamic sites), and may also involve cytokine activation. The central disturbances may reflect phenotypic variations of neuroendocrine processes or sensitization of such mechanisms. It is suggested that chronic stressor experiences or stressors encountered early in life lead to the phenotypic neurochemical alterations, which then favor the development of the dysthymic state. Owing to the persistence of the neurochemical disturbances, vulnerability to double depression is increased, and in this instance treatment with antidepressants may attenuate the symptoms of major depression but not those of the basal dysthymic state. Moreover, the residual features of depression following treatment may be indicative of underlying neurochemical disturbances, and may also serve to increase the probability of illness recurrence or relapse. Molecular Psychiatry (2000) 5, 242-261.

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“…This ®nding is in keeping with the ®ndings of an Austrian multicentre trial of moclobemide vs. imipramine which included 33 bipolar patients (15), but contrasts with a metaanalysis of clinical trials of moclobemide in depression in which MCB appeared to be superior to a range of comparators, including IMI, in the minority of patients who were deemed to have bipolar depression (7). In our study, all the patients were bipolar, and met the diagnostic criteria for bipolar disorder laid down in DSM-III-R.…”

Section: Discussionmentioning

confidence: 84%

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

Silverstone¹

2001

Acta Psychiatr Scand

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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

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Efficacy and Tolerability of Moclobemide Compared with Imipramine in Depressive Disorder (DSM-III): An Austrian Double-blind, Multicentre Study∗

Cited by 99 publications

References 6 publications

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Dysthymia: a review of pharmacological and behavioral factors

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

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