A reversible MAOI antidepressant
Moclobemide
A newer, reversible MAOI with far less dietary risk than older MAOIs, used for depression and social anxiety.
What is Moclobemide?
Moclobemide is a reversible inhibitor of monoamine oxidase A (a RIMA), a newer member of the MAOI family used for depression and social anxiety. Because its action is reversible and short-lasting, the dietary tyramine restriction is much less strict than with older MAOIs like phenelzine, though large amounts of tyramine-rich foods are still best avoided. It still interacts dangerously with other antidepressants and certain medicines, so care is needed when combining or switching treatments.
Education and reference only. This is a plain-language guide to Moclobemide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Moclobemide is an antidepressant in the MAOI family, but it works in a reversible way (a RIMA — reversible inhibitor of monoamine oxidase A). It is used for depression and for social anxiety disorder. Because its block on the enzyme is short-lived and reverses, it is much safer with food than the older, irreversible MAOIs, although it still needs respect for interactions with other medicines.
How it works
Moclobemide reversibly blocks monoamine oxidase A, the enzyme that breaks down mood-related brain chemicals such as serotonin and noradrenaline, so more of these become available to lift mood over a few weeks. Because the block is reversible and wears off, tyramine from food can still be handled to a large extent, which greatly reduces — though does not entirely remove — the dietary risk seen with older MAOIs.
Company & origin
Originated / developed by: Generic.
A reversible MAOI (RIMA) used in the UK for depression and social anxiety, with much less dietary restriction than older MAOIs.
What it treats
Conditions Moclobemide is used for
Practical use
How to take Moclobemide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it regularly as prescribed, usually after food, and allow a few weeks for the full benefit.
- You do not normally need the strict MAOI diet, but avoid eating very large amounts of tyramine-rich foods such as a lot of mature cheese.
- Do not start other antidepressants or certain medicines without advice, as combinations can be dangerous and may need a washout.
- Tell any doctor, dentist or pharmacist that you take an MAOI-type antidepressant, and check before buying cold or flu remedies.
- If you miss a dose, take it when you remember unless it is nearly time for the next, then skip it — do not double up, and do not stop suddenly.
Weighing it up
Advantages & disadvantages of Moclobemide
Advantages
- Much less dietary restriction than older, irreversible MAOIs.
- An option for depression and for social anxiety disorder.
- Generally better tolerated than the older MAOIs, with fewer food worries.
Disadvantages
- Still interacts dangerously with other antidepressants and some medicines.
- Switching antidepressants may still need a washout period and care.
- Like other antidepressants, it takes weeks to work and must not be stopped abruptly.
Practical use
Good to know
The big practical difference from older MAOIs is diet: with moclobemide the strict low-tyramine diet is not usually required, but it is still sensible to avoid eating very large amounts of tyramine-rich foods (such as a lot of mature cheese) and to take it after food. It still interacts dangerously with other antidepressants and with some other medicines, so combining or switching antidepressants needs care and sometimes a washout. Like all antidepressants it usually takes a few weeks to work, should not be stopped abruptly, and carries the general caution to watch for any worsening mood or distressing thoughts, especially early on or in younger adults. Tell any health professional that you take an MAOI-type medicine.
Who should not take it / use with caution
- It must not be combined with other antidepressants or certain medicines such as some painkillers and stimulants without specialist care.
- People with phaeochromocytoma or significant confusion or agitation states should not take it.
- Anyone who has had a serious reaction to it, or with certain severe medical conditions, should avoid it.
Monitoring
- Mood and any thoughts of self-harm are reviewed, especially in the first weeks and in younger adults.
- Blood pressure may be checked, and you are advised about warning signs of a reaction.
- Response and tolerability are reviewed before deciding to continue or change.
Side effects
- Sleep disturbance, dizziness, headache and nausea.
- Restlessness or agitation, and dry mouth.
- Less commonly, low sodium (causing confusion) or, with interacting medicines, serotonin-related reactions — seek advice.
Key interactions
- Other antidepressants, including SSRIs, must not be combined with it, and switching may need a washout.
- Some painkillers, decongestants and stimulant medicines can cause serious reactions.
- Large amounts of tyramine-rich foods, and certain other medicines, should be checked with a pharmacist.
Available as: Tablets taken by mouth.
Answers
Moclobemide: frequently asked questions
Do I need the strict MAOI diet?
Usually not, because moclobemide is reversible and much safer with food, but it is still wise to avoid very large amounts of tyramine-rich foods and to take it after food.
How is it different from older MAOIs?
Its block on the enzyme is reversible and short-lived, so the food risk is greatly reduced, though it still interacts with several medicines.
Can it be used for anxiety?
Yes, as well as depression it can be used for social anxiety disorder, under medical guidance.
Can I take other antidepressants with it?
No, combining it with other antidepressants can be dangerous; switching is done carefully and may need a washout period.
How long before it works?
Like other antidepressants it usually takes a few weeks to lift mood, so keep taking it and attend your reviews.
The wider class
About MAOI antidepressants (reversible)
Moclobemide belongs to the maoi antidepressants (reversible) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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