Three Suicide Attempts with Moclobemide

Iwersen, Stefanie; Schmoldt, A.

doi:10.3109/15563659609013774

Cited by 21 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analysis of the available SBP measurements taken prior to, during or after the severe headaches did not reveal any unusually elevated values. The type of adverse events at high moclobemide doses does not di¤er from those seen in the therapeutic dose range, and conÞrms the symptoms seen in cases of overdose with moclobemide as the sole ingestant (Hetzel 1992;Myrenfors et al 1993;Iwersen and Schmoldt 1996). The results of the IV tyramine pressor tests amongst recipients of 450 mg and 600 mg b.i.d.…”

Section: Discussionmentioning

confidence: 74%

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

et al. 1998

View full text Add to dashboard Cite

The objectives of this study were to assess the tolerability, safety, pharmacodynamics and pharmacokinetics of high-dose moclobemide in healthy subjects. Two sequential groups of six male and six female subjects (eight on active treatment, four on placebo) received for 8 days moclobemide 450 mg b.i.d. and 600 mg b.i.d., respectively. Intravenous tyramine pressor tests were conducted at baseline, at the beginning of treatment and at steady state. Oral tyramine pressor tests with 50, 100 and 150 mg tyramine were conducted under steady-state conditions. Pharmacokinetic parameters of moclobemide and two of its metabolites in plasma and urine were determined after the first and last dose of moclobemide. The incidence and intensity of adverse events was dose-dependent. The most frequently reported adverse events were insomnia, headache, dizziness and dry mouth. The i.v. tyramine pressor sensitivity during both moclobemide dosing regimens was enhanced 3 to 4-fold. Intake of tyramine 50 mg did not result in systolic blood pressure increases greater than 30 mmHg. With regard to blood pressure increases, tyramine 100 mg is still compatible with moclobemide 450 mg b.i.d. but not with 600 mg b.i.d. The clearance of moclobemide decreased by about 60% on multiple dosing, but no differences were found between both dosing regimens. The urinary excretion of the N-oxide metabolite doubled during multiple dosing. In conclusion, the maximum tolerated dose of moclobemide in healthy subjects is 600 mg b.i.d. provided the tyramine content in a meal is not higher than 50 mg.

show abstract

Section: Discussionmentioning

confidence: 74%

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Moclobemide has been extensively evaluated in the treatment of a wide spectrum of depressive disorders and social phobia. Overall, moclobemide appears to be safe and devoid of major side effects, although it is considered as a mild antidepressant, better tolerated by older patients [175][176][177][178][179][180][181]. Moclobemide undergoes extensive metabolism with less than 1 % of the dose being excreted unchanged.…”

Section: Inhibition Of Maomentioning

confidence: 99%

Mitochondrial Functions in Mood Disorders

Hroudová¹,

Fišar²,

Raboch³

2013

Mood Disorders

View full text Add to dashboard Cite

“…Information on coingestants taken in these five cases was based * P = 0.028; ** P = 0.034; *** P < 0.01; **** P = 0.020. NS, Not significant; 1 , all four had coingested a tricyclic antidepressant; 2 , all had coingested proconvulsant drugs: dothiepin, doxepin, venlafaxine (3) and thioridazine; 3 , asystole occurred in one patient who coingested metoprolol and ventricular tachycardia occurred in another who coingested dothiepin. on the history, and was confirmed in each case by HPLC (Table 3).…”

Section: Toxicokineticsmentioning

confidence: 99%

“…Some authors have concluded that the drug does not cause major toxicity and is far safer than tricyclic antidepressants [3,4]. However, there are reports of fatalities from moclobemide alone [5,6] and in combination with clomipramine [6][7][8][9][10], citalopram [8] and paroxetine [11].…”

Section: Introductionmentioning

confidence: 99%

Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity

Hackett

Dawson

Whyte

et al. 2003

Brit J Clinical Pharma

View full text Add to dashboard Cite

Aims To investigate the spectrum of toxicity of moclobemide overdose, the occurrence of serotonin toxicity, and to estimate toxicokinetic parameters. Methods All moclobemide overdoses presenting over a 10-year period to the Hunter Area Toxicology Service were reviewed. Clinical features, complications, length of stay (LOS) and intensive care (ICU) admission rate were extracted from a standardized, prospectively collected database. Comparisons were made between moclobemide alone and moclobemide with a serotonergic coingestant poisoning. Serotonin toxicity was defined by a combination of Sternbach's criteria and a clinical toxicologist's diagnosis. In five patients serial moclobemide concentrations were measured. Time to maximal plasma concentration ( T max ), peak plasma concentration ( C max ) and terminal elimination half-lives were estimated. Results Of 106 included patients, 33 ingested moclobemide alone, 21 ingested moclobemide with another serotonergic agent (in some cases in therapeutic doses) and 52 ingested moclobemide with a nonserotonergic agent. Eleven (55%) of 21 patients coingesting a serotonergic drug developed serotonin toxicity, which was significantly more than one (3%) of 33 moclobemide-alone overdoses (odds ratio 35, 95% confidence inteval 4, 307; P < 0.0001). In six of these 21 cases severe serotonin toxicity developed with temperature > 38.5 ∞ C and muscle rigidity requiring intubation and paralysis. The 21 patients had a significantly increased LOS (34 h) compared with moclobemide alone overdoses (12 h) ( P < 0.0001) and a significantly increased ICU admission rate of 57% vs. 3% ( P < 0.0001). Time to peak plasma concentration was delayed in two patients where prepeak samples were obtained. C max increased slightly with dose, but all three patients ingesting ≥ 6 g vomited or had charcoal. The mean elimination half-life of moclobemide in the five patients in whom serial moclobemide concentrations were measured was 6.3 h and elimination was first order in all cases. There was no evidence of a dose-dependent increase in half-life. Conclusions The effects of moclobemide alone in overdose are minor, even with massive ingestions. However, moclobemide overdose in combination with a serotonergic agent (even in normal therapeutic doses) can cause severe serotonin toxicity. The elimination half-life is prolonged by two to four times in overdose, compared with that found in healthy volunteers given therapeutic doses. This may be a result of wide interindividual variation in overall elimination, also seen with therapeutic doses, but appears not to be due to saturation of normal elimination pathways.

show abstract

Three Suicide Attempts with Moclobemide

Cited by 21 publications

References 12 publications

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

Clinical pharmacology of moclobemide during chronic administration of high doses to healthy subjects

Mitochondrial Functions in Mood Disorders

Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity

Contact Info

Product

Resources

About