Combination therapy using moclobemide with tricyclic and tetracyclic antidepressants to treat therapy-resistant depression

In an open trial, a combination therapy with 300 mg moclobemide was instituted after adjustment to a classical tricyclic or tetracyclic antidepressant in a group of 23 previously therapy-resistant depressive inpatients (pretreatment with two biochemically different antidepressants over a period of at least 5 weeks with sufficient doses). In 13 patients (53.9%) a significant improvement on the Hamilton Depression Scale (24-item version) of at least 50% was achieved. The improvement in the BPRS was also significant. On the basis of the present findings, a combination therapy with the reversible MAO-inhibitor moclobemide represents an efficacious regimen for therapy-resistant depressions, with low side-effects. After this pilot study, further controlled studies are necessary.