Citation

Singer P. J. Can. Soc. Forensic Sci. 2000; 33(3): 111-117.

Copyright

(Copyright © 2000, Canadian Society of Forensic Science, Publisher Informa - Taylor and Francis Group)

DOI

10.1080/00085030.2000.10757507

PMID

unavailable

Abstract

Moclobemide (Manerix™) is one of the first reversible inhibitors of monoamine-A (RIMA). It inhibits metabolism of norepinephrine, dopamine and, in particular, serotonin and as such is widely used as a second-line antidepressant. Alone it is usually benign in overdose, but in combination with other drugs that enhance synaptic concentrations of neurotransmitters there is the potential for fatal interactions. Medical Examiner's cases of moclobemide in combination with Serotonin Specific Reuptake Inhibitors (Case 1: moclobemide 9.4, paroxetine 1.1; Case 2: moclobemide 13.0, sertraline 1.5), with venlafaxine (Case 3: moclobemide 5.7, venlafaxine 1.1) and with cocaine (Case 4: moclobemide 2.1, benzoylecgonine 0.07) are presented (all levels are mg/L in postmortem blood). The combination of moclobemide overdose with reuptake blockers will sufficiently enhance neurotransmission to produce fatalities.