A number of studies suggest that no interaction, or only a moderate non-significant rise in tricyclic antidepressant levels occurs when they are given with
moclobemide. However, several case reports describe
serotonin syndrome, in patients receiving the combination. There is little evidence regarding mianserin, but it seems likely that it could interact similarly.
Concurrent use should be avoided.
Moclobemide has a short duration of action so no treatment free period is required before starting a tricyclic or related antidepressant. However, some recommend waiting 24 hours.
Moclobemide should not be started until at least one week after a tricyclic or related antidepressant has been stopped.