Meclobemide (Manerix, Aurorix)

Meclobemide is a new type of antidepressant that is related to the mono amine oxidase inhibitors (MAOI). Two subtypes of mono amine oxidase have recently been discovered; Type A and Type B. Meclobemide is 80% selective to Type A. It is also reversible and lasts for less than 24 hours in your body. These medications are called RIMA (Reversible Inhibitor of Monamine oxidase A) antidepressants.

Meclobemide increases concentrations of serotonin, dopamine and norephinephrine at nerve endings, a so-called "triple effect." Meclobemide has fewer interactions and side effects than older MAOIs and requires fewer dietary restrictions.

The Bottom Line: What You Really Need to Know

Meclobemide (Manerix) is used to treat depression and social anxiety disorder.
The usual beginning dose of meclobemide is 150 mg twice a day. After a week, the dose is increased to 300 mg twice a day. Be sure to take it exactly as your doctor directs.
Meclobemide interacts with many different medications. Make sure you tell your physician and pharmacist about all medications that you take, including herbal remedies and teas, over the counter medications, homeopathic and alternative treatments, vitamins, supplements and medications you only take occasionally.
Meclobemide does not react as strongly with tyramine as other MAOI antidepressants. It's still necessary to avoid high tyramine foods like wine and cheese. Be sure to follow any other dietary restrictions carefully.
If you have surgery, make sure your surgeon knows you take meclobemide. It can interact with anesthetics.
It may take two weeks or more before you start feeling better.
Talk to your doctor before you stop taking meclobemide. Your dose may need to be tapered down slowly to prevent uncomfortable withdrawal symptoms.
Most people experience a few mild side effects, like dry mouth, headache or dizziness, when they begin taking meclobemide. They usually go away with time.
If you experience loss of interest in sex or diminished sexual ability, talk to your doctor about it.
Meclobemide should be used with caution in pregnancy.
Have a friend or family member check in with you every day for the first few weeks that you take meclobemide. Ask him or her to help you monitor your condition for:

Worsening depression
Restlessness, irritability, agitation, hostility or aggression
Unusual thoughts or thoughts of suicide

Report any serious or unusual side effects to your doctor.

Uses of meclobemide

Meclobemide is used to treat depression and Social Affective Disorder (SAD). Ongoing research suggests that RIMA antidepressants may be helpful in treating other disorders, including Parkinson's disease.

Dosage and instructions

The usual dose of meclobemide is 300 mg twice a day. The initial dose is usually 150 mg twice a day after meals. After the first week, the dose is increased.

How meclobemide works

Meclobemide prevents the breakdown of serotonin, dopamine and norepinephrine in the nerve endings. This increases the levels of those chemicals, which are thought to help regulate mood and anxiety.

Side Effects

The most common side effects that people experience with meclobemide are dry mouth, headache, insomnia, nausea, dizziness, tremors, restlessness, rapid heart beat and low blood pressure. Other side effects that can occur are allergic reactions, increased confusion and anxiety, exacerbation of psychosis, rash, breast enlargement and milk secretion in both men and women (due to increased prolactin levels).

Interactions with other drugs

Concurrent use of other antidepressants-MAOIs, SSRIs, SNRIs and tricyclic antidepressants-can cause serotonin syndrome, a very serious and sometimes fatal toxicity syndrome. Dextromethorphan (cough medicine) and MDMA (ecstasy) can also cause serotonin syndrome if you are taking meclobemide.

Ephedrine, pseudoephedrine and similar drugs can cause a severe hypertensive crisis when taken with meclobemide. These medications are often found in over-the-counter cold, allergy and weight loss medications. They can be found in herbal teas, too. Amphetamine and methamphetamine can also cause severe hypertension.

Cimetadine (tagamet) increases the effect of meclobemide and a reduced dose is necessary

Meclobemide causes benzodiazepines (tranquilizers) to accumulate; the dosage of the tranquilizer may need to be decreased.

Unlike older MAOIs, meclobemide does not have as strong an interaction with the amino acid tyramine, which is found in many foods. Cheese and wines should still be avoided, but most other foods can be eaten while taking meclobemide.

Meclobemide interacts with anesthetics and should be stopped 48 hours before any elective surgery. You can start taking it again 24 hours after surgery.

Serious interactions can occur between meclobemide and thoridazine (Mellaril) or meperdine (Demerol).

Withdrawal

Abruptly stopping taking meclobemide can produce discontinuation symptoms, and they can be very uncomfortable. Symptoms can include headache, nausea, dizziness and weakness, bizarre dreams, agitation, restlessness and irritability. Most doctors prefer to taper meclobemide over a week or two rather than stopping it abruptly.

Warnings, precautions and contraindications

Confused states: Meclobemide has stimulant effects and can make agitation, confusion, delirium or psychosis worse. It should be used with caution in patients with any of these conditions.

Hypertension: Meclobemide is not as likely to cause high blood pressure as other MAOIs, but care should be taken in patients who have high blood pressure or who have illnesses that can increase blood pressure, such as thyrotoxicosis and pheochromocytoma.

Anti-Depressants.com