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Phenelzine

    Brands

    DEA Class;  Rx

    Common Brand Names; Nardil

    • Antidepressants, MAO Inhibitors

    Non-selective monoamine oxidase A and B inhibitor (MAOI) antidepressant
    FDA-approved for the treatment of major depressive disorder (MDD); used off-label as a second- or third-line agent for anxiety disorders such as panic disorder and social anxiety disorder
    Primarily used for treatment-resistant cases of depression and anxiety disorders, due to dietary restrictions, adverse effect profile, and the potential for serious drug-drug interactions and drug-food interactions

    Indicated for use in treatment-resistant depression, including atypical depression.

    For the treatment of panic disorder.
    For the treatment of social phobia (social anxiety disorder).

    Hypersensitivity

    Pheochromocytoma, congestive heart failure

    Within 10 days of elective surgery using general anesthesia or spinal anesthesia

    Liver disease, abnormal liver function tests, or history of hepatic disease

    Renal disease, severe renal impairment, ESRD

    Common

    • Orthostatic hypotension

    • Asthenia

    • Dizziness

    • Headache

    • Drowsiness

    • Fatigue

    • Hyperreflexia

    • Sleep disturbance

    • Somnolence

    • Weakness

    • Tremor

    • Constipation

    • Dry mouth

    • Weight gain

    Less Common

    • Confusion

    • Decreased memory

    • Paresthesia

    • Anorexia

    • Nausea

    • Vomiting

    • Impotence

    • Increased LFT’s

    • Nystagmus

    • Urinary frequency or retention

    Uncommon

    • Edema

    • Anxiety

    • Irritation

    • Hypomania

    • Hypermetabolic syndrome (hyperpyrexia, tachycardia, tachypnea, increased CPK, acidosis)

    • Arthralgia

    • SIADH

    Rare

    • Hypertensive crisis

    • Ataxia

    • Seizure

    • Worsening depression

    • Suicide

    • Edema of glottis

    • Leukopenia

    • Hepatic necrosis, jaundice

    • Drug-induced lupus erythematosus

    • Visual disturbance

    Orthostatic hypotension may occur

    Hypertensive reactions may occur from consumption of foods high in tyramine or supplements containing caffeine, tyrosine, tryptophan, phenylalanine, or phenylalanine

    Not first-line therapy

    Discontinue 10 days before surgery

    Therapy not approved for treating any indications in the pediatric population

    Most serious reactions involve changes in blood pressure

    Therapy may cause excessive stimulation in schizophrenic patients

    Drug potentiates hexobarbital hypnosis in animals; barbiturates should be given at a reduced dose with phenelzine

    Drug should be used with caution in diabetes mellitus; increased insulin sensitivity may occur; requirements for insulin or oral hypoglycemics may be decreased; there is conflicting evidence as to whether or not MAO inhibitors affect glucose metabolism or potentiate hypoglycemic agents; this should be kept in mind if drug is administered to diabetics

    Pregnancy Category: C

    Lactation: unknown; use caution

    Adults

    90 mg/day PO.

    Geriatric

    90 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Phenelzine sulfate 

    tablet

    • 15mg