Efficacy and Tolerability of Moclobemide in Comparison with Placebo, Tricyclic Antidepressants, and Selective Serotonin Reuptake Inhibitors in Elderly Depressed Patients: A Clinical Overview

Feb 20, 1998Canadian journal of psychiatry. Revue canadienne de psychiatrie

How well moclobemide works and is tolerated compared to placebo, older antidepressants, and SSRIs in elderly depression

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Abstract

The response rate to moclobemide in depressed patients aged 60 years and older was 50% to 55%.

Moclobemide demonstrated efficacy comparable to both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).
Tolerability of moclobemide was rated as 'very good' or 'good' in almost 90% of elderly patients.
Patients receiving moclobemide reported fewer adverse events compared to those treated with TCAs or SSRIs.
Anticholinergic adverse events occurred more frequently with TCAs than with moclobemide.
Nausea was reported three times more often in patients treated with SSRIs compared to those on moclobemide.

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OBJECTIVE: To review the efficacy and safety of moclobemide in comparison with TCAs (for our purposes, "TCAs" will represent tricyclic and tetracyclic antidepressants, including maprotilin and mianserin) and selective serotonin reuptake inhibitors (SSRIs) in elderly depressed patients.

METHODS: The efficacy data reviewed were obtained from the following sources: 1) results of published studies in the elderly; 2) data on patients aged > or = 60 years extracted from all available controlled trials in adults (> or = 18 years) in which moclobemide was compared with TCAs or SSRIs; and 3) the adverse events were extracted for patients aged > or = 60 years from the safety data base of all available comparative short-term studies with moclobemide versus TCAs, SSRIs, or placebo and of long-term studies with moclobemide.

RESULTS: The data show that moclobemide is an effective antidepressant in depressed patients aged > or = 60 years. The response rate to moclobemide was 50% to 55% in this population. Moclobemide was more effective than placebo and was of similar efficacy to the TCAs and the more recently introduced SSRIs. The tolerability of moclobemide was rated as "very good" or "good" in almost 90% of these patients, which was better than the tolerability of TCAs and similar to that of SSRIs. Patients without any adverse events were more frequently found in the moclobemide group than in those treated with TCAs (P < 0.01) or SSRIs (P < 0.01). Adverse events of the anticholinergic type were more frequent with TCAs than with moclobemide (P < 0.001), and nausea was found 3 times more frequently with SSRIs than with moclobemide (P < 0.01).

CONCLUSIONS: Moclobemide is an effective and well-tolerated antidepressant for the treatment of elderly depressed patients.

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Efficacy and Tolerability of Moclobemide in Comparison with Placebo, Tricyclic Antidepressants, and Selective Serotonin Reuptake Inhibitors in Elderly Depressed Patients: A Clinical Overview

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