Moclobemide and the Risk of Serotonin Toxicity (or Serotonin Syndrome)

Abstract

Comments on an article 'Moclobemide: Therapeutic Use and Clinical Studies,' by Udo Bonnet (see record [rid]2003-00467-005[/rid]). Recent and important developments in our understanding of serotonin toxicity (ST) or serotonin syndrome (SS) (4,15,23) contribute to an informative re-interpretation of the risk of ST with all drugs, especially with the moclobemide-serotonin reuptake inhibitor (SRI) combinations mentioned in Bonnet's review. Bonnet's statement 'this combination has rarely been associated with a potentially lethal serotonin syndrome' is neither precisely formulated nor explained and may be misconstrued. There are a number of reports of serious ST with therapeutic doses of moclobemide combined with SRIs, some noted by Bonnet, as well as other cases. Both life-threatening toxicity, and also actual deaths, from 'overdoses' of moclobemide. Moclobemide, if combined with any SRI, produces a significant risk of severe ST and also the possibility of fatalities even with 'therapeutic' doses. There is no substantive evidence of significant therapeutic benefit. (PsycINFO Database Record (c) 2016 APA, all rights reserved)