Moclobemide

RIMA·Psychiatry - Antidepressants

Major Depressive Disorder, Social Phobia

PBSRIMAAurorix, Amira150 mg tabletS4+1

Max Dose

600 mg/day

Half-life

1-2 h

Diet Restrictions

MINIMAL

Interactions

HIGH

Rapid Summary

Overview

Reversible Inhibitor of Monoamine Oxidase A (RIMA). Provides the unique efficacy of an MAOI without the terrifying, strict dietary restrictions (cheese effect).

Maximum Dose

Max 600 mg/day (e.g., 300 mg BD).

Clinical Focus

While food interactions are rare, the drug interactions are STILL FATAL. Mixing Moclobemide with an SSRI will cause fatal Serotonin Syndrome.

Bottom Line

Moclobemide is a reversible MAOI (RIMA) for depression with fewer dietary restrictions than irreversible MAOIs, but still carries serotonin syndrome risk and requires a washout period from other antidepressants.

Formulation & Access

Brand Names

Aurorix, Amira

Oral Routes

Tablets (150 mg, 300 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder, Social Phobia.

Clinical Place

A highly underutilized, excellent drug for social anxiety and atypical depression. Safer than irreversible MAOIs (Phenelzine).

Quick reference

Class & Role

RIMA — Reversible Inhibitor of Monoamine Oxidase A (RIMA).

Route / Formulation

Tablets (150 mg, 300 mg). (Aurorix, Amira)

Usual Dose & Max

Start PO 150 mg BD (after meals). Titrate to 300-600 mg/day in divided doses. Max 600 mg/day (e.g., 300 mg BD).

Key Indication Doses

Major Depressive Disorder: Start PO 150 mg BD (after meals). Titrate to 300-600 mg/day in divided doses. Social Anxiety: PO 300 mg BD.

Best Uses

Avoid / Cautions

Concurrent use of SSRIs, SNRIs, TCAs, Pethidine, or Tramadol. Pregnancy Category B3.

Key Risks

Neurological: Insomnia, dizziness, agitation, headache. CRITICAL — Serotonin Syndrome (if mixed with serotonergics). Gastrointestinal: Nausea, dry mouth. Metabolic: Weight neutral. Zero sexual dysfunction.

Key Interactions

ANY serotonergic drug (SSRIs, MDMA, Dextromethorphan cough syrup). Will cause hyperthermia, seizures, and death. Cimetidine (doubles moclobemide levels).

Monitoring

Must be taken strictly AFTER MEALS. This slows absorption and minimizes the peak concentration in the gut, reducing the tiny remaining risk of a tyramine (cheese) reaction. No specific routine laboratory tests required.

Clinical Pearl

Patients do NOT need a strict MAOI diet on Moclobemide. They can eat cheese and drink wine normally. The only exception is if they consume a *massive* amount of mature cheese (e.g., 200g of pure aged cheddar in one sitting), which could overwhelm the reversible blockade and cause a mild BP spike.

Access

Aurorix, Amira150 mg tablet

Brand: Aurorix, Amira
Formulation: Tablets (150 mg, 300 mg)