Moclamine (Moclobemide)

Moclamine is a reversible MAO‑A inhibitor indicated for depressive and anxiety disorders.

• Major depressive disorder: alleviates depressive symptoms and improves mood.
• Social anxiety disorder: reduces anxiety and improves social functioning.

• Moclobemide selectively and reversibly inhibits the enzyme monoamine oxidase A, preventing the breakdown of serotonin, norepinephrine and dopamine. This increases the synaptic concentrations of these neurotransmitters, enhancing mood regulation and reducing depressive and anxiety symptoms.

Moclamine may cause a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Headache: transient cranial discomfort.
• Dizziness: sensation of light‑headedness, especially on standing.
• Insomnia: difficulty initiating or maintaining sleep.
• Dry mouth: reduced salivation.
• Constipation: infrequent bowel movements.

Serious or Rare Side Effects

• Hypertensive crisis: sudden severe rise in blood pressure, often triggered by tyramine‑rich foods.
• Serotonin syndrome: agitation, hyperthermia, tremor when combined with serotonergic agents.
• Severe liver injury: jaundice, elevated liver enzymes.
• Agranulocytosis: marked reduction in white blood cells, increasing infection risk.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Psychosis: emergence of hallucinations or delusional thoughts.

Before initiating Moclamine, several safety considerations are recommended.

• Hepatic assessment: evaluate liver function because the drug is metabolised hepatically.
• Blood pressure monitoring: watch for hypertensive episodes, especially after high‑tyramine meals.
• Dietary restrictions: avoid tyramine‑rich foods such as aged cheeses, cured meats and certain alcoholic beverages.
• Serotonergic agents: do not combine with SSRIs, SNRIs, tricyclic antidepressants or linezolid without specialist supervision.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Moclamine interacts with several drug classes; careful management is required.

Major Interactions (Avoid)

• Other MAO inhibitors: concurrent use can cause severe hypertensive reactions.
• SSRIs, SNRIs, tricyclic antidepressants: risk of serotonin syndrome.
• Linezolid or methylene blue: potent MAO inhibition leading to hypertensive crisis.

Moderate Interactions (Monitor Closely)

• NSAIDs: may increase bleeding risk when combined with MAO inhibition.
• Antihypertensive agents: possible additive blood pressure effects; monitor levels.