Moclobemide

Moclobemide, sold under the brand names Amira, Aurorix, Clobemix, Depnil and Manerix among others, is a reversible inhibitor of monoamine oxidase A (RIMA) drug primarily used to treat depression and social anxiety. It is not approved for use in the United States, but is approved in other Western countries such as Canada, the United Kingdom and Australia. It is produced by affiliates of the Hoffmann–La Roche pharmaceutical company. Initially, Aurorix was also marketed by Roche in South Africa, but was withdrawn after its patent rights expired and Cipla Medpro's Depnil and Pharma Dynamic's Clorix became available at half the cost. Moclobemide differs from the classic monoamine oxidase inhibitors (MAOIs) in that it selectively and reversibly inhibits monoamine oxidase A. Its interaction with dietary tyramine is consequently weaker and shorter-lived; special dietary restrictions are generally not required at standard therapeutic doses, although prescribing information advises avoiding large amounts of tyramine-rich foods. With classic MAOIs, a tyramine-restricted diet remains recommended because excessive tyramine can provoke a hypertensive reaction; however, modern food-production standards have reduced tyramine levels in most foods, and contemporary guidance focuses on a relatively small number of higher-risk foods. Moclobemide nevertheless has clinically important interactions with some serotonergic and sympathomimetic drugs. Moclobemide was first introduced for medical use in 1989.