Generic Name: Phenelzine Sulfate
Brand Names: Nardil
Drug Class: MAOIs
Similar Class Drugs: Selegiline, Isocarboxazid
Available Dosage Form: Oral tablet
What is Phenelzine?
Phenelzine is used to treat depression without an established endogenous cause. In medical terminology, such category of depression is commonly referred “Atypical depression.” Mood disorders coupled with depression in young women warrants the prescription of Phenelzine if other drugs fail to provide optimum results.1 The FDA approved the prescription of Phenelzine to treat patients with atypical depression having mixed anxiety and depression and hypochondriacal features.
It is also used off-label to treat:
-Treatment-resistant depression
-OCD
-PTSD
-Panic disorder
-ADD
-Eating disorders
-Angina pectoris
-Idiopathic facial pain
-Weight loss in obese patients
Phenelzine impedes the progress of depression through the blockade of enzymes monoamine oxidase A, B. Both enzymes catabolize mood regulatory monoamine neurotransmitters (serotonin, dopamine, and norepinephrine). Phenelzine delays the uptake of monoamines and makes them available to elicit their mood-enhancing effects.
Rare instances of acute liver injury have raised concern over the use of Phenelzine for long-term treatment. Production of a metabolite toxic to liver cells elevates serum aminotransferase levels. However, the alteration in liver function is transient and resolves independently without the change of dosage or cessation of treatment. MAOIs should not be prescribed in patients with a documented acute liver injury.2
How to use Phenelzine?
Phenelzine should be used as directed by your doctor.
-The initial dosage is a 15 mg tablet three times a day
-Dosage is usually increased rapidly to 60 mg per day if patients tolerate it well
-The maintenance dose following maximum benefit from the drug is a 15 mg tablet per day or every other day.
-Your doctor will adjust dosages after evaluating the progress of the treatment
-Avoid taking Phenelzine with foods and beverages containing caffeine (tea or coffee), tyramine (cheese and wine), and tryptophan
-Tell your doctor if you have asthma and the medications you take for its management
What are the side effects of Phenelzine?
Common side effects of Phenelzine:
-Insomnia
-Dry mouth
-Drowsiness
-Dizziness
-Weight changes
-Constipation
Although severe side effects are rare, they include:
-Ataxia
-Manic Reaction
-Jaundice
-Leukopenia
-Hypoxia
Who should not use Phenelzine?
Patients with the following conditions should not use Phenelzine:
-Hypersensitivity to Phenelzine
-Congestive heart failure
-History of liver disease
References
- Sidhu G, Marwaha R. Phenelzine. [Updated 2021 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554508/
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Phenelzine. [Updated 2020 Apr 8].Available from: https://www.ncbi.nlm.nih.gov/books/NBK548402/
