Moclobemide Versus Fluoxetine for Major Depressive Episodes

Geerts, S.; Bruynooghe, F; Cuyper, H De; Demeulemeester, F.; Haazen, L.

doi:10.1097/00002826-199417001-00007

Cited by 20 publications

(6 citation statements)

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“…This was interpreted to result primarily from the non-sedative action of moclobemide. However, a similar more rapid onset of action of moclobemide has been reported also in comparative study with fluoxetine (31,91,94). The question arises, therefore, whether the more rapid onset of action could result from an earlier effect on negative symptom dimensions of major depression, such as anhedonia, blunted affect and retardation.…”

Section: Meta-analyses and Analyses In Different Subtypes Of Depressionsupporting

confidence: 54%

“…Three studies reported that the onset of the antidepressant action of moclobemide was shorter than that of SSRIs. After 7 to 10 days of treatment the HAM-D scores or the CGI were significantly more improved in patients on moclobemide than on fluoxetine (31,91,94). However, a recent meta-analysis of the data of 440 fluoxetine-treated and 437 moclobemide-treated patients provided by Hoffmann-La Roche revealed no significant difference in the time course of recovery between the two groups (219).…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 98%

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Moclobemide: Therapeutic Use and Clinical Studies

Bonnet¹

2003

CNS Drug Reviews

205

100

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Moclobemide is a reversible inhibitor of monoamine-oxidase-A (RIMA) and has been extensively evaluated in the treatment of a wide spectrum of depressive disorders and less extensively studied in anxiety disorders. Nearly all meta-analyses and most comparative studies indicated that in the acute management of depression this drug is more efficacious than placebo and as efficacious as tricyclic (or some heterocyclic) antidepressants or selective serotonin reuptake inhibitors (SSRIs). There is a growing evidence that moclobemide is not inferior to other antidepressants in the treatment of subtypes of depression, such as dysthymia, endogenous (unipolar and bipolar), reactive, atypical, agitated, and retarded depression as with other antidepressants limited evidence suggests that moclobemide has consistent long-term efficacy. However, more controlled studies addressing this issue are needed. For patients with bipolar depression the risk of developing mania seems to be not higher with moclobemide than with other antidepressants. The effective therapeutic dose range for moclobemide in most acute phase trials was 300 to 600 mg, divided in 2 to 3 doses. While one controlled trial and one long-term open-label study found moclobemide to be efficacious in social phobia, three controlled trials subsequently revealed either no effect or less robust effects with the tendency of higher doses (600 -900 mg /d) to be more efficacious. Two comparative trials demonstrated moclobemide to be as efficacious as fluoxetine or clomipramine in patients suffering from panic disorder. Placebocontrolled trials in this indication are, however, still lacking.A relationship between the plasma concentration of moclobemide and its therapeutic efficacy is not apparent but a positive correlation with adverse events has been found. Dizziness, nausea and insomnia occurred more frequently on moclobemide than on placebo. Due to negligible anticholinergic and antihistaminic actions, moclobemide has been better tolerated than tri-or heterocyclic antidepressants. Gastrointestinal side effects and, espe-97

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Section: Meta-analyses and Analyses In Different Subtypes Of Depressionsupporting

confidence: 54%

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 98%

Moclobemide: Therapeutic Use and Clinical Studies

Bonnet¹

2003

CNS Drug Reviews

205

100

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“…The remaining 4 studies contained data that had previously been published in 1 of the 12 studies identified for inclusion in the metaanalysis (21-24) (see Figure 1 for details). The 12 studies we pooled involved a total of 1207 outpatients with MDD randomized to treatment with either moclobemide or one of fluoxetine (10,11,(25)(26)(27)(28)(29), fluvoxamine (30,31), sertraline (9,12), or paroxetine (13). None of these 12 studies involved the use of placebo.…”

Section: Resultsmentioning

confidence: 99%

A Metaanalysis of Clinical Trials Comparing Moclobemide with Selective Serotonin Reuptake Inhibitors for the Treatment of Major Depressive Disorder

Papakostas

Fava

2006

Can J Psychiatry

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“…Psychological therapy for residual symptoms or risk of relapse may be appropriate later. [129,135,190], § § [152,[191][192][193][194][195], ¶ ¶ [146,186], † † † [132,153,[196][197][198], ‡ ‡ ‡ [128,130,134,199], § § § [55,[200][201][202], ¶ ¶ ¶ [66,68,80,124,203], † † † † [80,124].…”

Section: Severe Depression Without Psychosismentioning

confidence: 99%

Australian and New Zealand Clinical Practice Guidelines for the Treatment of Depression

Ellis

Australian²

2004

Aust N Z J Psychiatry

139

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Establish an effective therapeutic relationship; provide the patient with information about the condition, the rationale for treatment, the likelihood of a positive response and the expected timeframe; consider the patient's strengths, life stresses and supports. Treatment choice depends on the clinician's skills and the patient's circumstances and preferences, and should be guided but not determined by these guidelines. In moderately severe depression, all recognized antidepressants, cognitive behavioural therapy (CBT) and interpersonal psychotherapy (IPT) are equally effective; clinicians should consider treatment burdens as well as benefits, including side-effects and toxicity. In severe depression, antidepressant treatment should precede psychological therapy. For depression with psychosis, electroconvulsive therapy (ECT) or a tricyclic combined with an antipsychotic are equally helpful. Treatments for other subtypes are discussed. Caution is necessary in people on other medication or with medical conditions. If response to an adequate trial of a first-line treatment is poor, another evidence-based treatment should be used. Second opinions are useful. Depression has a high rate of recurrence and efforts to reduce this are crucial.

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Moclobemide Versus Fluoxetine for Major Depressive Episodes

Cited by 20 publications

References 0 publications

Moclobemide: Therapeutic Use and Clinical Studies

Moclobemide: Therapeutic Use and Clinical Studies

A Metaanalysis of Clinical Trials Comparing Moclobemide with Selective Serotonin Reuptake Inhibitors for the Treatment of Major Depressive Disorder

Australian and New Zealand Clinical Practice Guidelines for the Treatment of Depression

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