Talk:Moclobemide

message: Someone should add on the possible lethal/quite dangerous interaction with MDMA. 
http://www.blackwell-synergy.com/servlet/useragent?func=synergy&synergyAction=showAbstract&doi=10.1046/j.1360-0443.2003.00292.x
:Any MAOI will have a potentially lethal interaction with MDMA ;)
:Moclobemide doesn't have less potential for interaction than the traditional MAOIs, it just has less dietary restrictions, and a less complicated metabolism. Zuiram 18:55, 24 November 2006 (UTC)
replies: text: @Zuiram I think a warning is a good idea, but I question the idea that it doesn't have less potential for interaction than traditional MAOIs. From the article: "Serotonin syndrome has been reported when moclobemide has been taken in combination with other serotonin enhancing drugs; however, due to moclobemide's reversible MAO inhibition, serotonin syndrome is significantly less likely to occur with moclobemide than with older irreversible MAOIs." Yeltommo (talk) 07:01, 27 March 2023 (UTC)
thread_title:  MDMA 

message: The following text:
:Unlike standard MAOIs, possible side effects do not include cardiovascular complications (hypertension) with encephalopathy, liver toxicity or hyperthermia.
Is a bit misleading. First off, hepatotoxicity and such complications are linked to the older MAOIs that are no longer in use. Of the current generation, only Nardil carries any significant potential for hepatotoxicity. Hypertension and hyperthermia are related to dietary and drug interactions, and remain an issue with moclobemide, although it will take more of the offending substance to cause it with typical doses of moclobemide. And someone should elaborate on what kind of encephalopathy they feel is common with the unselective MAOIs.
Zuiram 19:04, 24 November 2006 (UTC)
replies: text: @Zuiram I agree that it's misleading at best. But doesn't isocarboxazid, as a hydrazine derivative, also have the potential for hepatotoxicity? In any case. tranylcypromine does not. Frankly, the article comes across a little like an advertisement, excessively influenced by manufacturer marketing and/or initial hopes and enthusiasm. Maybe I should create a separate topic. Yeltommo (talk) 07:05, 27 March 2023 (UTC)
thread_title:  Standard MAOIs comparison 

message: Does anyone know whether this drug is under review by the FDA for approval? (I sent an email to the manufacturer.) 
Also, does anyone know *why* it's not approved in the U.S.? Historian932 (talk) 15:43, 28 June 2008 (UTC)
thread_title:  Information on legal status in U.S. 

message: "In general, combination of an MAOI with any serotonergic substance is not advised, due to the possibility of dangerous increases in blood pressure."
While taking substances that release serotonin in combination with an MAO-A inhibitor is obviously a major risk of serotonin syndrome and death - substances like DMT, LSD, Psilocin, Mescaline, etc work directly at the serotonin receptor and so I cant see how an MAOI would increase the pressor effects of these 5-HT2A agonists enough to produce significant hypertension. Admittedly as these substances are metabolized by MAO Moclobemide will raise their plasma levels but if this was an issue then taking less would prevent the problem. I also don't think that even absurdly high levels of any 5-HT2A agonist could produce hypertension via that receptor, it is not that uncommon for people to take shockingly high doses of the classical psychedelics without suffering any effect on their physical health. The toxicity of the classical 5-HT2A agonists is such that you can take 1000 times the normal dose without any risk to health. This is not the case for 2C-B though and many others as they have a much higher toxicity. I heard a report of 2C-B in combination with the MAO-B inhibitor Deprenyl causing sub-clinical hypertension (140/100 or similar). The only reason 2C-B has the capacity to elevate blood pressure that much is that it is an alpha1-adrenaline agonist(1) like amphetamine/cocaine. Deprenyl is known to potentiate the pressor response to alpha1-adrenaline(2) so this probabley had nothing to do with the MAO inhibition anyway. To conclude - all of the classical serotonergic psychedelics (DMT, LSD, psiloc[yb]in, mescaline) are clearly safe in combination with moclobemide - while the safety of combining the newer synthetic psychedelics - 2C-B, 2C-E, 2C-I, DOB, DOI, AMT, AET, etc - is less certain. Personally I would feel comfortable taking moclobemide in combination with 2C-B, 2C-E or 2C-I but not with any of the other research chemicals.
I'm going to remove that sentance as it is misleading.
Note: subsequent research has shown that alpha2c is the relevant adrenaline receptor for 2c-b's stimulatory effects, not alpha1 as is noted - source = psychedelics and the human receptorome, also i have combined selegiline with moclobemide (5mg and 150mg respectively) w/o complication  —Preceding unsigned comment added by 64.131.209.208 (talk) 07:20, 27 February 2010 (UTC)
thread_title:  Interactions with Serotonergics 

message: This article needs to be cleaned up. The same things are being repeated over and over again and the article is neither well structured or formatted.  — Preceding unsigned comment added by 83.227.15.37 (talk) 03:07, 11 March 2013 (UTC)
replies: text: In addition, there is some contradictory information: "Adverse events occur more often in females than in males" vs "The tolerability of moclobemide is similar in woman and men". SelfishSeahorse (talk) 16:45, 3 November 2013 (UTC)
thread_title:  Cleanup 

message: Frankly, the article comes across a little like an advertisement, excessively influenced by manufacturer marketing and/or initial hopes and enthusiasm. One example: "Reversible selective MAOIs such as moclobemide are widely underprescribed due to the misconception that the side effect profiles are analogous to that of the irreversible and non-selective MAOIs." 
The cited article is from 1997. Psychiatrists aren't the brightest bunch, but it's not credible that they (still) wouldn't understand that there's a significant difference between irreversible and reversible MAOIs.  The more likely reason it hasn't been prescribed much in the 25+ years since that article was written is that it's not very effective, especially when used alone, despite the RCTs suggesting otherwise. RCTs can be manipulated or interpreted to show all kinds of things that aren't observed in clinical practice.
This is just one example. The article is chock full of enthusiastic claims. Yeltommo (talk) 07:18, 27 March 2023 (UTC)
thread_title:  Bias 

message: There is much conflicting information about the use of moclobemide in social phobia which is not conveyed in this Wikipedia article. Here are two examples:
* "Moclobemide has been found to be effective for the treatment of social anxiety disorder in both short and long-term placebo controlled clinical trials"
* "The use of moclobemide in the treatment of social anxiety disorder has given mixed results with a tendency of response at higher doses (>300 mg/d) compared with placebo."
I have looked at multiple sources and they generally seem to either slightly prefer moclobemide or there is no difference compared to placebo. I think this section needs to be tidied up and a disclaimer be put that research on social phobia is inconclusive. Huragok97 (talk) 19:11, 15 June 2023 (UTC)
thread_title:  Social phobia