moclobemide + paroxetine

This is a combination of two antidepressant drugs: moclobemide, a reversible inhibitor of monoamine oxidase A (MAO-A), and paroxetine, a selective serotonin reuptake inhibitor (SSRI). Moclobemide increases synaptic concentrations of serotonin and noradrenaline by inhibiting their breakdown, while paroxetine blocks the reuptake of serotonin into presynaptic neurons, further increasing serotonergic activity. The rationale for combining these agents is to enhance antidepressant efficacy in treatment-resistant depression. However, this combination carries significant risk due to pharmacodynamic interactions that can lead to severe adverse effects—including life-threatening serotonin syndrome—even at therapeutic doses. Reported side effects include insomnia, dizziness, headache, nausea, dry mouth, myoclonic jerks, hypomania, akathisia and in some cases severe toxicity or death[1][3][4][5][6]. The efficacy data are limited and largely unproven; use is generally discouraged except under specialist supervision for refractory cases.

Brand names

Manerix + Paxil

Other names

moclobemide and paroxetineMAOI (moclobemide) plus SSRI (paroxetine)