Tranylcypromine

Generic Name: Tranylcypromine

Brand Names: Parnate

Drug Class: MAOIs

Similar Class Drugs: Selegiline, Isocarboxazid

Available Dosage Form: Oral tablet

What is Tranylcypromine?

Tranylcypromine irreversibly inhibits MAO enzymes to elicit its anti-depressive effects against major depressive disorder (MDD) in adults. FDA approved the use of Tranylcypromine for treatment-resistant depression in patients that have failed treatments with first-line agents. Evidence suggests that the surge in MAO enzyme catabolism of monoamines alters the mood regulatory mechanisms of the brain and manifests as mood sensitivity, disturbed sleep, and dysregulated appetite.¹

Administration of Tranylcypromine is frequently indicated for patients in whom Electroconvulsive therapy proves ineffectual in curbing depressive symptoms. Tranylcypromine has been implicated in the treatment of bipolar depression in individuals with predominant psychomotor retardation

Several Tranylcypromine prescriptions have plummeted after the emergence of recently released agents for depression. Inconclusive therapeutic studies and concerns regarding the adverse toxicity profile have added to the reduction in its use.¹

Considering the complexities involved indirect access to the human brain, the process of determining the pathophysiology of psychotropic disorders and the advancement in research continues to stay sluggish.

 How to use Tranylcypromine?

• The recommended dosage is 30 mg/day in divided doses
• If patients do not respond adequately to the initial dose, the dosage is increased in increments of 10 mg/day every 1-3 weeks until the maximum dose of 60 mg/day in divided doses of 30 mg is reached.
• You can take Tranylcypromine with or without food
• Abstain from consuming food rich in tyramine. For example, aged cheese, cured meat or poultry, avocados, tap beers, and soy sauce
• Tell your doctor if you suffer from low blood pressure

What are the side effects of Tranylcypromine?

Human pluripotent stem cells employed to form brain tissue (organoids) introduced advancement in traditional research practices on mouse models.² Infusion of Tranylcypromine in human brain organoids has disclosed the neurotoxic potential of the drug and additional adverse effects in long-term treatment.

Some documented life-threatening adverse events with Tranylcypromine include:

-Serotonin syndrome

-Orthostatic hypotension

-Hypertensive crisis

-Suicidal behavior

-Hepatotoxicity

-Seizures

-Emergence of mania

Common side effects include:

-Headache

-Insomnia

-Dry mouth

-Dizziness

-Constipation

Who should not use Tranylcypromine?

-Those undergoing treatment with drugs that interact with Tranylcypromine

-Patients with known hypersensitivity to the drug and its components

References

1. Cameron Kiani. Tranylcypromine: Its Pharmacology, Safety, and Efficacy Kiani, American Journal of Psychiatry Residents’ Journal Published: 16 June 2020. Available from:
2. Huang J, Liu F, Tang H, et al. Tranylcypromine Causes Neurotoxicity and Represses BHC110/LSD1 in Human-Induced Pluripotent Stem Cell-Derived Cerebral Organoids Model. Front Neurol. 2017;8:626. Published 2017 Dec 7. doi:10.3389/fneur.2017.00626