Moclobemide is one of the first reversible inhibitors of monoamine-A and has a better safety profile than older monoamine oxidase inhibitors. It inhibits the metabolism of norepinephrine, dopamine, and serotonin and is widely used as a second-line antidepressant. It is usually benign in overdose when taken alone. However, it has the potential for fatal interactions when taken in combination with other drugs that enhance synaptic concentrations of neurotransmitters. The four case histories came from the office of the chief medical examiner in Edmonton, Alberta, Canada. These cases involved moclobemide in combination with paroxetine, sertraline, venlafaxine, cocaine, and benzoylecgonine. The individuals included a 32-year-old male with a history of street and prescription drug abuse, a 23-year-old male with a history of two prior head injuries as well as drug and alcohol abuse, a 33-year-old white female, and a 29-year-old male. The study concluded that the body cannot sufficiently compensate when a person takes moclobemide in combination with reuptake inhibitors, including selective serotonin reuptake inhibitors, cocaine, and other drugs, and the combination greatly increases the likelihood of death. Tables and 30 references (Author abstract modified)