The combined treatment of therapy-resistant depression with moclobemide and maprotilin

In a prospective, non-comparative, open study 5 depressed patients therapy-resistant to at least two previous antidepressive treatments of appropriate dosage and duration were treated for 3 weeks with moclobemide monotherapy (450 to 600 mg/d), thereafter with a combination of moclobemide (450 to 600 mg/d) and maprotiline (75 to 150 mg/d). Three of these patients improved within 3 weeks of combination treatment, two of them "much" or "very much", respectively. Tolerability of the combined treatment was good without any evidence of an increased rate of adverse events compared to pretreatment with moclobemide alone. The reported adverse events corresponded well with those known to occur with mono-therapy of the involved antidepressants or spontaneously during depression. The combined treatment with moclobemide and maprotiline in clinically relevant dosages revealed to be an effective treatment option in therapy-resistant depression, which is well tolerated without evidence of an increased risk for patients.