Twelve RCTs (n=1,207) were included; the numbers of patients ranged from 40 to 209. All of the included studies were sponsored by the manufacturer of moclobermide.
There were no statistically significant differences in response rates between moclobemide and SSRI treatment groups; the pooled RR was 1.08 (95% CI: 0.92, 1.26, p=0.314). There were no statistically significant relationships between the mean moclobemide dosage and the RR of response rates. There was no evidence of statistical heterogeneity among the included studies (p=0.958).
There were no statistically significant between-group differences in overall discontinuation rates, discontinuation rates due to adverse events, or discontinuation rates due to lack of efficacy.
SSRI treatment was associated with higher rates of nausea (RR 0.6, 95% CI: 0.5, 0.8, p=0.001), headaches (RR 0.6, 95% CI: 0.5, 0.8, p=0.001) and treatment-emergent anxiety (RR 0.5, 95% CI: 0.2, 0.9, p=0.029) when compared with treatment with moclobemide. There were no statistically significant between-group differences in rates of fatigue and somnolence, nor in rates of insomnia.
There was no evidence of publication bias (p=0.643).