Double-blind comparison of moclobemide and tranylcypromine in depression.

Moclobemide is the first of a new generation of reversible inhibitors of monoamine oxidase-A (RIMA) with no clinically relevant potentiation of the hypertensive actions of dietary tyramine. The present study was conducted to compare the efficacy and safety of moclobemide with an established irreversible monoamine oxidase inhibitor, tranylcypromine, in depressed patients. Patients were randomized to receive moclobemide (81 patients) or tranylcypromine (79 patients) at individually titrated doses (100-300 mg/day of moclobemide and 10-30 mg/day of tranylcypromine) under double-blind conditions for at least four weeks, in a multicenter trial. Antidepressant efficacy was assessed using items 1-17 of the Hamilton depression rating scale (HAMD-17), the von Zerssen 'Befindlichkeits' scales, a visual analog scale and the clinicians' global impression. Both treatments resulted in significant amelioration of depression as determined by all rating instruments. HAMD-17 scores were reduced by 63% and 58% with moclobemide and tranylcypromine respectively, although the difference between the groups was not significant. The other rating instruments yielded similar results, apart from the clinician's assessment of efficacy at day 28. In this assessment, efficacy was rated as very good/good in 78% of moclobemide treated patients and in 88% of the tranylcypromine treated patients; however, only patients who had not dropped out of the trial were included in this assessment. The tolerability of both drugs was good, although moclobemide appeared to possess a small advantage in this regard since only one patient in this group was prematurely withdrawn from the trial due to inadequate tolerability/adverse events, compared with nine withdrawals in the tranylcypromine group.(ABSTRACT TRUNCATED AT 250 WORDS)

Moclobemide (Ro 11-1163) versus desipramine in the treatment of endogenous depression.

Moclobemide was compared with desipramine in 30 patients with endogenous depression. The Hamilton Rating Scale for Depression showed significantly greater improvement for moclobemide (69%) than for desipramine (45%). The final assessment of tolerance was good or very good in 87% of moclobemide patients compared with 13% of desipramine patients; 5 patients in the first group and all 15 in the second group complained of adverse effects. One patient on moclobemide and 5 on desipramine stopped treatment prematurely because of poor tolerance; no patients stopped treatment because of lack of efficacy. Assessment in this study was made difficult by concomitant treatment with benzodiazepines and/or mild neuroleptics in both groups, but the results of efficacy and tolerance clearly favour moclobemide over desipramine in the treatment of endogenous depression in hospitalized patients.

Moclobemide (Ro 11-1163) versus tranylcypromine in the treatment of endogenous depression.

In this study, moclobemide (100-350 mg daily) was compared with tranylcypromine (10-30 mg daily) in 40 patients with endogenous depression. Treatment was randomly allocated and most patients also received benzodiazepines or mild neuroleptics concomitantly. Improvement on the Hamilton Rating Scale for Depression at the end of treatment was 66% for moclobemide and 41% for tranylcypromine patients. There were 3 suspected tyramine reactions in patients on tranylcypromine. Tolerance was considered good or very good for 95% of moclobemide patients, and for 75% of tranylcypromine patients. No clinically relevant changes in laboratory data were attributed to either of the trial drugs. The results clearly favour moclobemide over tranylcypromine for both efficacy and tolerance in the treatment of endogenous depression.