Antidepressant drug therapy: associated risks

Abstract

Aspects of risks associated with treatment with three classes of antidepressants: tricyclic (TCA), second generation ("new") antidepressants and monoamine oxidase inhibitor (MAOI), are discussed. Moclobemide, a benzamide derivative, is a new MAOI antidepressant with reversible and preferential inhibition of the A-form of monoamine oxidase. Moclobemide is free of liver toxicity and the risk of a pressor response with tyramine-containing food is so low that strict diet restrictions are unnecessary. That MAOIs have a low incidence of side effects, particularly so called anticholinergic side effects is also true for moclobemide. A serious risk with antidepressant drugs is that the patient will use them to attempt suicide. Therefore important aspects of antidepressants are that they should take effect rapidly and be safe in overdose. No deaths from overdose have been observed with toloxatone, the only reversible MAOI antidepressant on the market to date. It is concluded that the new reversible MAOI antidepressant moclobemide is similar to other antidepressants in terms of efficacy but very noticeably superior in terms of tolerance and safety.