(Legend)

Generic Name

• MAOIs: Phenelzine
  Tranylcypromine
  Isocarboxazid
  T½ = Unknown [See selegiline patch]
  Pregnancy category C

Trade Name

• Nardil
• Parnate
• Marplan

Dose Range/Adult Daily Dose

• Phenelzine:
• Range: 45–90 mg/d
• Start: 15 mg po 3 × daily and increase to 60–90 mg/d.
• Tranylcypromine:
• Range: 30–60 mg/d
• Start: 30 mg/d po divided dose (AM/PM) up to 60 mg/d.
• Isocarboxazid:
• Range: 20–60 mg/d
• Start: 10 mg/d po, increasing every few days (up to 60 mg/d in 2–4 divided doses)

Use/Common Side Effects (CSE)

• Use: Atypical depression, panic disorder; other Rx ineffective or not tolerated
  CSE: Dizziness, headaches, insomnia, restlessness, blurred vision, arrhythmias, orthostatic hypotension, diarrhea, SEIZURES, HYPERTENSIVE CRISIS

Geriatric & Dose Considerations

• Use cautiously, titrate slowly, ↑ risk of adverse reactions

Classification

• Antidepressant

Assessment Cautions

• Potentially fatal reactions with other antidepressants (SSRIs, TCAs, etc). 5-wk washout w fluoxetine. Must follow MAOI diet (foods high in tyramine) to avoid hypertensive crisis (emergency) [See MAOI diet in Drug-Labs tab]; hypertensive crisis from caffeine; also amphetamines, levadopa, dopamine, epinephrine, reserpine, and others. Avoid opioids (meperidine).