Monoamine-Oxidase Inhibitors

Nardil/Phenelzine and Parnate/Tranylcypromine

MAOI's are used to treat depression and anxiety disorders.

Proper use of this medication:

    * This medication is not addictive, and does not cause a high feeling.
    * Take this medication exactly as directed. Do not take more of it and do not take it more often than prescribed. Do not miss any doses.
    * If you do miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
    * When taken regularly, this medication may require 2-4 weeks before the full effects are noticed.
    * Do not drink alcohol while taking this medication.
    * If there is a possibility you may become pregnant or breast-feed while on this medication, first consult with your psychiatrist.
    * This medication should not be discontinued without first consulting with your psychiatrist, as severe withdrawal reactions (frightening dreams & confusion) may occur.
    * Take a daily multi-vitamin with pyridoxine while taking MAO inhibitors.
    * Store this medication in a cool, safe place away from the reach of children.

This medication is usually very well tolerated. However possible side effects include:

    * Dry mouth: This usually goes away in several weeks. Chew sugarless gum or suck on sugarless (especially sour) candy. Drink plenty of fluids. Brush your teeth at least twice daily.
    * Dizziness: This may be due to low blood pressure. Dizziness may occur when you get up quickly or rapidly change positions. Arise or change positions slowly. This tends to occur only the first 2 months of treatment or with dosage increases. Taking all the dose at bedtime, or taking several smaller doses during the day may be helpful. Contact your physician before making any dosage changes.
    * Drowsiness: This is usually transient, lasting up to several months.
    * Insomnia: This is not common. Discuss this with your physician, as temporary addition of a sleeping pill may be helpful.
    * Tremor: This is an uncommon side effect, which may improve with continued use of the medication.
    * Sexual difficulties: Decreased sexual desire and difficulty achieving orgasm may occur. Discuss this with your physician for treatment options.
    * Rash: This is unusual, but should be reported to your physician.
    * Sudden high blood pressure: This may occur with ingestion of foods or drugs listed below. If you develop symptoms of severe headache, sweating, neck stiffness, fast heart rate, muscle tremor or elevated blood pressure, report to an emergency department immediately.
    * If any side effect persists or becomes intolerable, discuss this with your physician.

The following other medications should not be taken while taking MAOI's without first consulting your psychiatrist:

    * Serotonin Reuptake Inhibitors (Fluoxetine, Prozac, Paroxetine/Paxil, Sertraline/Zoloft, Fluvoxamine/Luvox, Venlafaxine/Effexor, Buspirone/Buspar).
    * Cyclic Antidepressants (Amitriptyline/Elavil, Nortriptyline/Pamelor, Protriptyline/Vivactil, Clomipramine/Anafranil, Imipramine/Tofranil, Desipramine/Norpramin, Trimipramine/Surmontil, Amoxapine/Asendin, Doxepin/Adapin/Sinequan, Maprotiline/Ludiomil, Trazodone).
    * Stimulants and decongestants (amphetamines, ephedrine, epinephrine, norepinephrine, isoproterenol, methylphenidate/Ritalin, phenylephrine, phenylpropanolamine, pseudoephedrine, etc.). Some of these medications are commonly found in over-the-counter cold preparations and appetite suppressants. Includes decongestant nasal sprays.
    * Dextromethorphan (found in many over-the-counter cold preparations).
    * Synthetic narcotics (Demerol/meperidine, Buprenorphine/Buprenex, Propoxyphene/Darvon, Fentanyl/Duragesic, Nalbuphine/Nubain, Butorphanol/Stadol, etc.)
    * Sinemet/L-dopa, Reserpine, Risperidone/Risperdol, St.John's Wort.
    * Barbiturates may cause excessive sedation.
    * Medications used to treat diabetes may result in excessively low blood sugar.
    * Ginkgo biloba may interfere with effectiveness.

Sudden and severe high blood pressure may occur with (including 14 days after the medication is discontinued) the following foods:

    * All cheeses (including sour cream) except: cream cheese, american cheese, ricotta, cottage cheese, yogurt.
    * Drinks: Beer, sherry, chianti and other red wines, all distilled alcohols.
    * Yeast/protein extracts (Yeast is safe when baked, for example in bread).
    * Smoked or pickled meats (including fish and other seafoods).
    * Beef or chicken livers.
    * Fermented sausages, such as bologna, pepperoni, salami, and summer sausage.
    * Fruits: avocados, figs, raisins, banana peel.
    * Fermented bean curd: soya beans, soya paste, soy sauce.
    * Fava or broad beans.
    * Large amounts of caffeine or chocolate.
    * Other high-protein foods that have undergone degeneration (e.g. old leftovers).

Copyright 2007 Pharmacy Associates

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