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It is generally considered dangerous to combine monoamine oxidase inhibitors and SSRIs because MAOIs inhibit serotonin metabolism and can result in circulating serotonin levels that are high enough to produce cardiotoxic and neurotoxic serotonin syndrome. This Swiss study from the manufacturer of the reversible inhibitor of MAO-A moclobemide suggests that this interaction does not occur with moclobemide.
Eighteen healthy subjects took 40 mg/day of fluoxetine for a week and then 20 mg/day for about two more weeks. After two weeks on fluoxetine, subjects were randomized to add placebo or moclobemide in doses that were gradually increased to 600 mg/day. Fluoxetine increased moclobemide plasma levels, but not to levels that were considered clini…