phenelzine (Nardil, Sinerval)
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Introduction
Tradename: Nardil. (phenelzine sulfate)
Indications
- treatment of atypical, non-endogenous or neurotic depression in patients who do not respond to traditional antidepressants
- bulimia nervosa
Contraindications
Dosage
- start 15 mg PO TID
- after 2-6 weeks, decrease to 15 mg/day, or less in divided doses
- avoid bedtime dosing
Tabs: 15 mg.
Pharmacokinetics
- onset of action: may take 2-4 weeks
- eliminated in urine
- may have therapeutic effects & produce drug interactions for 2 weeks after discontinuation
elimination via liver
Adverse effects
- common (> 10%)
- orthostatic hypotension, blurred vision, drowsiness, weakness, trembling, sexual dysfunction
- less common (1-10%)
- uncommon (< 1%)
- other[2]
- hypertensive crisis may occur with tyramine-containing foods
- drug adverse effects of MAO inhibitors
- drug adverse effects of antidepressants
- drug adverse effects of psychotropic agents
Drug interactions
- guanethidine, reserpine, tyramine, tryptophan, caffeine in combination may result in hypertensive crisis
- selective serotonin reuptake inhibitors#, tricyclic antidepressants, trazodone, dextromethorphan, sympathomimetics, meperidine, tramadol, buspirone in combination may result in serotonin syndrome
- disulfiram
- antihypertensive agents
* a 2 week washout period is recommended prior to use of any of these agents
# a 6 week washout is recommended after discontinuation of fluoxetine
- drug interaction(s) of benzodiazepines with antidepressants
- drug interaction(s) of antidepressants with benzodiazepines
- drug interaction(s) of beta-adrenergic receptor antagonists with MAO inhibitors
- drug interaction(s) of NSAIDs with antidepressants
- drug interaction(s) of MAO inhibitor with caffeine
Mechanism of action
- inhibits monoamine oxidase
- increases concentration of epinephrine, norepinephrine, dopamine & serotonin
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ 2.0 2.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Deprecated Reference