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This link has been bookmarked by 1 people . It was first bookmarked on 22 Dec 2006, by Mud Doccy.

22 Dec 06

Mud Doccy
drugs maois moclobemide ocd research scientific
- Moclobemide Response in Obsessive–Compulsive Disorder Dear Sir: Moclobemide is a reversible inhibitor of monoamine oxidase A (RIMA) acting solely on monoamine oxidase A (MAO-A), the enzyme primarily involved in serotonin and norepinephrine degradation (1). Moclobemide is a benzamide derivative that is structurally different from classic MAO-inhibitors. It has no affinity to muscarinic, dopaminergic, serotonergic, adrenergic, opioid, or benzodiazepine receptors (2). Reversible inhibition of enzyme A occurs and, as a result, moclobemide has only a slight potentiating effect on the hypertensive action of tyramine (3). Comparative studies of moclobemide show that it has efficacy equal to that of tricyclic antidepressants (TCAs) with a better side effect profile in both elderly and young patients (4). In addition to treating major depression, the RIMA has also been shown to be effective in treating social phobia, dysthymia, panic disorders, and attention-deficit hyperactivity disorder (5). Here, I present a case of a female patient with severe obsessive–compulsive disorder (OCD) who has shown an excellent response to moclobemide, with a lower side effect profile. WS is a 36-year-old woman with a 15-year history of severe OCD. Her symptoms include doubts about praying (she prays about 3 hours daily, where the average for her religion is 30 minutes daily) and an irrational fear of contamination (which is difficult for her to ignore) followed by washing rituals. For example, she would spend a total of 2½ hours daily in the washroom, washing her hands approximately 40–50 times in total. Initially she was treated with behaviour modification techniques (exposure and response prevention) and paroxetine 40 mg daily. This treatment produced a dramatic reduction in her obsessions and compulsions within 6 weeks. She complained, however, of anorgasmia and decreased libido. She was then treated with fluoxetine 40 mg daily, but her sexual dysfunction worsened. The patient was then started on moclobemide 600 mg daily, and she maintained her improvement in symptoms without experiencing any sexual difficulties. The patient attempted to stop moclobemide on one occasion but experienced a severe recurrence of her symptoms, which improved significantly following reinstitution of moclobemide. The patient maintained good improvement after 6 months’ follow-up. The fact that moclobemide has significant serotonic reuptake inhibition indicates that moclobemide might play a role in the treatment of OCD, as demonstrated in this case. However, more systematic studies are needed to confirm this report.

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