Phenelzine

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Phenelzine Brand Name– Nardil

What is Phenelzine

Phenelzine is an oral antidepressant of the monoamine oxidase inhibitor (MAOI) class.

Due to the dietary restrictions required for MAOI use, as well as their side effect profile and the potential for serious drug-drug and drug-food interactions, MAOIs are primarily considered an option for major depressive disorder (MDD) that is refractory to treatment with other antidepressants.

MAOIs may be particularly effective for MDD with atypical features, and are recommended in some treatment guidelines for refractory cases of anxiety disorders such as social anxiety disorder and panic disorder.

Phenelzine was approved by the FDA in 1959.

Indications

  • depression
  • panic disorder
  • social phobia (social anxiety disorder)

For use in treatment-resistant depression, including atypical depression

Side Effects

  1. agitation
  2. agranulocytosis
  3. anemia
  4. anxiety
  5. appetite stimulation
  6. ataxia
  7. blurred vision
  8. coma
  9. constipation
  10. delirium
  11. depression
  12. dizziness
  13. drowsiness
  14. dysarthria
  15. ejaculation dysfunction
  16. elevated hepatic enzymes
  17. euphoria
  18. fatigue
  19. headache
  20. hepatitis
  21. hyperhidrosis
  22. hypernatremia
  23. hyperreflexia
  24. hypertension
  25. hypertensive crisis
  26. impotence (erectile dysfunction)
  27. insomnia
  28. intracranial bleeding
  29. jaundice
  30. leukopenia
  31. lupus-like symptoms
  32. mania
  33. metabolic acidosis
  34. myoclonia
  35. nystagmus
  36. orgasm dysfunction
  37. orthostatic hypotension
  38. palpitations
  39. paresthesias
  40. peripheral edema
  41. pruritus
  42. pseudoparkinsonism
  43. psychosis
  44. rash
  45. seizures
  46. serotonin syndrome
  47. suicidal ideation
  48. syncope
  49. thrombocytopenia
  50. tremor
  51. urinary retention
  52. vitamin B6 deficiency
  53. weakness
  54. weight gain
  55. withdrawal
  56. xerostomia

Monitoring Parameters

  • blood pressure
  • heart rate
  • LFTs
  • serum creatinine/BUN

Contraindications

  • abrupt discontinuation
  • acute myocardial infarction
  • alcoholism
  • angina
  • anuria
  • anxiety
  • asthma
  • bipolar disorder
  • breast-feeding
  • bronchitis
  • cardiac disease
  • cerebrovascular disease
  • children
  • coadministration with other CNS depressants
  • dental work
  • diabetes mellitus
  • driving or operating machinery
  • ethanol ingestion
  • geriatric
  • head trauma
  • headache
  • heart failure
  • hepatic disease
  • hepatitis
  • hypertension
  • hypertensive crisis
  • hyperthyroidism
  • hypotension
  • increased intracranial pressure
  • intracranial bleeding
  • mania
  • MAOI therapy
  • orthostatic hypotension
  • pheochromocytoma
  • pregnancy
  • psychosis
  • radiographic contrast administration
  • renal disease
  • renal failure
  • renal impairment
  • schizophrenia
  • seizure disorder
  • seizures
  • spinal anesthesia
  • stroke
  • substance abuse
  • suicidal ideation
  • surgery

Interactions

  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Almotriptan
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-blockers
  • Alpha-glucosidase Inhibitors
  • Alprazolam
  • Altretamine
  • Ambrisentan
  • Amide local anesthetics
  • Amifampridine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amoxapine
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Anxiolytics; Sedatives; and Hypnotics
  • Apraclonidine
  • Armodafinil
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzonatate
  • Beta-adrenergic blockers
  • Beta-agonists
  • Betaxolol
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bosentan
  • Bretylium
  • Brimonidine
  • Brimonidine; Brinzolamide
  • Brimonidine; Timolol
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bumetanide
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Caffeine
  • Caffeine; Ergotamine
  • Calcium-channel blockers
  • Canagliflozin
  • Canagliflozin; Metformin
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carteolol
  • Carvedilol
  • Cenobamate
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorothiazide
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Clevidipine
  • Clomipramine
  • Clonazepam
  • Clonidine
  • Clorazepate
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Cyclobenzaprine
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Desflurane
  • Desipramine
  • Desmopressin
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Diazoxide
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Dolasetron
  • Dorzolamide; Timolol
  • Doxazosin
  • Doxepin
  • Dronabinol
  • Droperidol
  • Droxidopa
  • Duloxetine
  • Eletriptan
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Entacapone
  • Eplerenone
  • Epoprostenol
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Esketamine
  • Eslicarbazepine
  • Esmolol
  • Estazolam
  • Ester local anesthetics
  • Ethacrynic Acid
  • Ethanol
  • Etomidate
  • Felbamate
  • Felodipine
  • Fenfluramine
  • Fenoldopam
  • Fentanyl
  • Fluphenazine
  • Flurazepam
  • food
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fospropofol
  • Frovatriptan
  • Furosemide
  • Gabapentin
  • Gallium Ga 68 Dotatate
  • General anesthetics
  • Ginseng, Panax ginseng
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Granisetron
  • Green Tea
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanabenz
  • Guanfacine
  • Halothane
  • Homatropine; Hydrocodone
  • Hydantoins
  • Hydralazine
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Oxycodone
  • Iloprost
  • Imipramine
  • Incretin Mimetics
  • Indapamide
  • Insulins
  • Iobenguane I 131
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Irbesartan
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Isosulfan Blue
  • Isradipine
  • Ketamine
  • Labetalol
  • Lamotrigine
  • Lasmiditan
  • Lemborexant
  • Levetiracetam
  • Levobetaxolol
  • Levobunolol
  • Levocetirizine
  • Levodopa
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Linagliptin
  • Linagliptin; Metformin
  • Lisinopril
  • Lithium
  • Loop diuretics
  • Lorazepam
  • Lorcaserin
  • Losartan
  • Loxapine
  • Magnesium Salts
  • Mannitol
  • Maprotiline
  • Meglitinides
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Mesoridazine
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methadone
  • Methazolamide
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methohexital
  • Methyclothiazide
  • Methyldopa
  • Methylene Blue
  • Metoclopramide
  • Metolazone
  • Metoprolol
  • Midazolam
  • Milnacipran
  • Minoxidil
  • Mirabegron
  • Mirtazapine
  • Mivacurium
  • Modafinil
  • Moexipril
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nadolol
  • Nalbuphine
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nateglinide
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Netupitant, Fosnetupitant; Palonosetron
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nitroglycerin
  • Nitroprusside
  • Non-Ionic Contrast Media
  • Nortriptyline
  • Olmesartan
  • Ondansetron
  • Oxazepam
  • Oxcarbazepine
  • Oxycodone
  • Oxymetazoline
  • Oxymorphone
  • Ozanimod
  • Palonosetron
  • Penbutolol
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Perindopril
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenoxybenzamine
  • Phentolamine
  • Phenylephrine; Promethazine
  • Pindolol
  • Potassium-sparing diuretics
  • Pramlintide
  • Prazosin
  • Pregabalin
  • Primidone
  • Procaine
  • Procarbazine
  • Prochlorperazine
  • Promethazine
  • Propofol
  • Propoxyphene
  • Propranolol
  • Protriptyline
  • Quazepam
  • Quinapril
  • Ramelteon
  • Ramipril
  • Rasagiline
  • Remifentanil
  • Repaglinide
  • Reserpine
  • Rizatriptan
  • Sacubitril; Valsartan
  • Safinamide
  • Saxagliptin
  • Secobarbital
  • Sedating H1-blockers
  • Selective norepinephrine reuptake inhibitors
  • Selective serotonin reuptake inhibitors
  • Selegiline
  • Serotonin norepinephrine reuptake inhibitors
  • Sevoflurane
  • Sibutramine
  • Sildenafil
  • Simvastatin; Sitagliptin
  • Sitagliptin
  • Sodium Oxybate
  • Solriamfetol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Succinimides
  • Succinylcholine
  • Sufentanil
  • Sulfonylureas
  • Sumatriptan
  • Suvorexant
  • Sympathomimetics
  • Tapentadol
  • Tedizolid
  • Telmisartan
  • Temazepam
  • Terazosin
  • Tetrabenazine
  • Tetracaine
  • Tetrahydrozoline
  • Thiazide diuretics
  • Thiazolidinediones
  • Thiopental
  • Thioridazine
  • Thiothixene
  • Tiagabine
  • Timolol
  • Tolcapone
  • Torsemide
  • Tramadol
  • Trandolapril
  • Trandolapril; Verapamil
  • Trazodone
  • Treprostinil
  • Triamterene
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Valbenazine
  • Valerian, Valeriana officinalis
  • Valproic Acid, Divalproex Sodium
  • Valsartan
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Vortioxetine
  • Yohimbine
  • Zolmitriptan
  • Zonisamide

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