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Information about Aurorix ®

active ingredient: moclobemide

AD(H)D is a congenital condition, resulting in a less self-controlled brain. The level of neurotransmitter noradrenaline in the brain is (default from birth) lower than in typical brains, making it less vigilant, so to say a bit sleepy. Noradrenaline prepares the cells in the brain to be alert. This is what makes medicine for the treatment of ADHD successful: all effective medications raise the level of noradrenaline.

For medical-ethical reasons, it is desirable to start medical treatment with an effective medication which produces the least non-desired side effects. That medication is moclobemide (brand name Aurorix).

The Aurorix patient information leaflet mentions approximately 28 side effects; Ritalin (methylphenidate) – the most common prescribed medication – around 100 or more.

Equisto coaching company psychiatrist, Akke Meilink MD, recommends therefor starting medicinal treatment of ADHD using moclobemide.

Moclobemide raises both the level of noradrenaline and serotonin in the brain; in treating ADHD the higher level of noradrenaline is needed. (In treating depression, moclobemide, taken three times a day, causes the level of serotonin to be more permanently raised but not so when dealing with ADHD.)

The effect of moclobemide is immediate: alertness and self-control improve immediately.

It is a moderate agent; necessary quantities therefor vary from 75 mg up to 900, sometimes even 1500 mg daily. Treatment best starts with 150 mg once a day – preferably during breakfast – and may be raised with 150 (or 75) per week, until the most effective dose is reached. Many people find 300 mg daily satisfying. Dosage may vary with the speed in which moclobemide is being processed in the body; in exceptional cases taking it twice a day may be advised.

Moclobemide is classified as a so-called MAO-A inhibitor. These kinds of medication usually need a strict diet program to prevent extreme high blood pressure, but not so when using moclobemide. (It is advised, though, to be moderate in the consumption of food high in tyramine or fermented food, like old cheese, Marmite and red wine.) Methylphenidate medication is known to give unwanted interaction with alcohol; moclobemide does not interact with alcohol.

It can be prescribed in combination with methylphenidate, but not in combination with other medication that raises the level of serotonin. Unwanted side effects are few; they consist mostly of …….

In The Netherlands moclobemide is officially registered by the Dutch Medicine Evaluation Board for treatment for depression in adults, so moclobemide is prescribed ‘off label’ for ADHD in children and adults. We advise prescribers to always explicitly discuss the use of moclobemide in comparison to other medication, both with the client and the family doctor. In the current Dutch health care insurance system the costs are fully compensated but are a part of the so called ‘private risk’.