An update of recent moclobemide interaction data

The classical monoamine oxidase inhibitors (MAOIs) are believed to have serious risks because of interactions with other drugs and foodstuffs, although not with a sound scientific basis in all cases. However, moclobemide, a selective reversible inhibitor of MAO-A, has a low propensity for producing drug interactions. Interaction studies have been carried out in healthy volunteers in an attempt to answer some relevant practical questions related to therapy with moclobemide. In combination with therapeutic doses of either fluvoxamine or fluoxetine, moclobemide did not provide any indication of a serotoninergic syndrome, so that no wash-out period is needed when switching from a selective serotonin re-uptake inhibitor to moclobemide or vice versa. Since concomitant treatment with moclobemide and selegiline had a supra-additive effect on the sensitivity to intravenously administered tyramine, that combination therapy should only be considered when accompanied by dietary restrictions. Concomitant treatment with moclobemide and levodopa/benserazide, however, was well tolerated. When oral ephedrine was added to steady-state moclobemide treatment, the cardiovascular effects of the former were increased to about the same extent as for oral tyramine, i.e. a potentiation of 2-4.