Major depressive disorder
Third line
Reversible MAO-A inhibitor (RIMA) for major depressive disorder. SEPB places moclobemide as third-line after SSRI and SNRI failure.
Reversible MAO-A inhibitor (RIMA)
ATC code: N06AG02 (Moclobemide)
Brand names
Manerix, Aurorix
Reversibly inhibits monoamine oxidase A and raises serotonin, norepinephrine and dopamine in the synapse. Half-life is short (1–4 hours) and enzyme activity returns within a day of withdrawal. Tyramine reaction is mild compared with irreversible MAO inhibitors. Do not combine with SSRIs, SNRIs, triptans, tramadol or linezolid – serotonin syndrome risk.
Third line
Reversible MAO-A inhibitor (RIMA) for major depressive disorder. SEPB places moclobemide as third-line after SSRI and SNRI failure.
Third line
Treats social anxiety disorder as an SSRI alternative. AEMPS backs moclobemide when patients do not tolerate first-line therapy.
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FDA Category C. Pregnancy data are limited. RIMA (reversible MAO-A inhibitor) is theoretically safer than irreversible MAO inhibitors, but pregnancy experience is limited. SEPB prefers SSRIs (sertraline) for depression in pregnancy.
Compatible with caution. Hale L3. Transfers into milk in small amounts (RID about 1%). Infants are monitored for sedation or irritability.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Moclobemide is evaluated for the following indications with varying evidence strength: Major depressive disorder (evidence tier B), Social anxiety disorder (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Moclobemide (≥ 1 in 100): Dry mouth, Headache, Insomnia, Nausea, Dizziness. See the Safety section for uncommon and serious reactions.
FDA category C. FDA Category C. Pregnancy data are limited. RIMA (reversible MAO-A inhibitor) is theoretically safer than irreversible MAO inhibitors, but pregnancy experience is limited. SEPB prefers SSRIs (sertraline) for depression in pregnancy.
Compatible with caution. Hale L3. Transfers into milk in small amounts (RID about 1%). Infants are monitored for sedation or irritability.
Moclobemide is contraindicated in: Hypersensitivity to moclobemide; Acute confusional state; Phaeochromocytoma; Co-administration with serotonergic drugs (SSRIs, SNRIs, TCAs, pethidine, tramadol, dextromethorphan, triptans); Co-administration with sympathomimetics. Full list in the Safety section.