Moclobemide (Manerix)

Moclobemide (Tradename: Manerix) is a reversible inhibitor of monoamine oxidase A (RIMA) used in the treatment of major depressive disorder and social anxiety.

Pharmacokinetics of Moclobemide

Moclobemide: Cytochrome P450 Metabolism

Substrate of (Metabolized by)
Induces
Inhibits

Moclobemide selectively and reversibly inhibits monoamine oxidase A (MAO-A). This inhibition decreases the metabolism and destruction of monoamines in synapses. This results in an increase in the monoamines.

  • In overdose, moclobemide alone is relatively safe. However, a combination overdose with moclobemide plus an SSRI/SNRI may be lethal.
  • Major depressive disorder
  • Social anxiety disorder

Dosing for Moclobemide

Starting
Titration
Maximum
Taper
  • Moclobemide comes in

Even though moclobemide is an MAOI, it does not mean the patient needs to have special dietary restrictions. Clinical studies have shown that up to 100 mg tyramine can be safely ingested during treatment on moclobemide doses of up to 600 mg per daily (when given after meals). 100 mg of tyramine is the equivalent of 1,000 g to 2,000 grams of mild cheese, or 200 grams strong cheese, or 70 grams Marmite yeast extract![1]

  • May be the best tolerated antidepressant as there are no sexual side effects and no dietary restrictions as might be required in other MAOIs.