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Monoamine Oxidase InhibitorAka: MAO inhibitor, Phenelzine, Nardil, Tranylcypromine, Parnate

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  1. Indications: Comorbid Depression
    1. Anxiety Disorder
    2. Atypical Depression
    3. Refractory Depression
    4. Bulimia
    5. Social Phobia
  2. Mechanism
    1. Inhibits monoamine oxidase
    2. Increases synaptic concentration of monoamines
      1. Serotonin
      2. Norepinephrine
  3. Precautions
    1. Tyramine-free diet must be followed
      1. Continue for two weeks after stopping medication
      2. See Tyramine Containing Foods
    2. Stop 2 weeks before starting another Antidepressant
    3. Taper Nardil slowly when stopping
      1. See Antidepressant Withdrawal
      2. Reduce dose by 15 mg/day every 2 weeks (or 10%/week)
  4. Preparations: Hydrazine
    1. Isocarboxazid (Marplan): No longer manufactured in U.S.
      1. Dosing: 10 mg PO bid
      2. Maximum: 60 mg per day
    2. Phenelzine (Nardil)
      1. Dosing: 15 mg PO tid
      2. Maximum: 90 mg per day
  5. Preparations Non-hydrazine
    1. Tranylcypromine (Parnate)
      1. Dosing: 10-40 mg/day in divided doses
      2. Maximum: 60 mg per day
    2. Parkinsonian agents
      1. Selegiline (Eldepryl)
  6. Complications
    1. Hypertensive Crisis (life-threatening)
      1. Occurs if tyramine or Sympathomimetic exposure
    2. Serotonin Syndrome
      1. Occurs with concurrent use of Serotoninergic drug
  7. Drug Interactions (Do not use with these medications)
    1. Tyramine Containing Foods
    2. Sympathomimetics (Ephedra, Ephedrine)
    3. Serotoninergic medications
    4. Selective Serotonin Reuptake Inhibitors (SSRI)
  8. Adverse Effects
    1. Anti-Histaminergic effects
      1. Dizziness
      2. Sedation
      3. Orthostatic Hypotension
      4. Weight gain
    2. Dopaminergic effects
      1. Insomnia
      2. Myoclonal jerks
    3. Serotoninergic Effects
      1. Sexual dysfunction
      2. Headache
    4. Anticholinergic Toxicity
      1. Dry Mouth
      2. Constipation
      3. Blurred Vision
      4. Urinary hesitancy
      5. Nausea
      6. Memory Dysfunction
    5. Other Effects
      1. Peripheral edema
      2. Weakness

Phenelzine (C0031392)

Definition (MSH)One of the MONOAMINE OXIDASE INHIBITORS used to treat DEPRESSION; PHOBIC DISORDERS; and PANIC.
Definition (CSP)monoamine oxidase inhibitor used to treat depression and phobic disorders.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD010624
English2 Phenethylhydrazine, 2-Phenethylhydrazine, beta Phenylethylhydrazine, beta-Phenylethylhydrazine, Fenelzin, MAOI - Phenelzine, Phenelzine, PHENELZINE PREPARATION, Phenethylhydrazine
Spanishfenelcina, fenelzina
Parent ConceptsMonoamine Oxidase Inhibitors (C0026457), Antidepressive Agents (C0003289), Hydrazines (C0020233), [CN602] MONOAMINE OXIDASE INHIBITOR ANTIDEPRESSANTS (C0973505), Monoamine oxidase A inhibitor (C1629501), Monoamine Oxidase (Type A) Inhibitors (C1579359)
SourcesAOD, CSP, LNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Tranylcypromine (C0040778)

Definition (MSH)A propylamine formed from the cyclization of the side chain of amphetamine. This monoamine oxidase inhibitor is effective in the treatment of major depression, dysthymic disorder, and atypical depression. It also is useful in panic and phobic disorders. (From AMA Drug Evaluations Annual, 1994, p311)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD014191
EnglishMAOI - Tranylcypromine, trans 2 Phenylcyclopropylamine, trans-2-Phenylcyclopropylamine, Tranylcypromine, TRANYLCYPROMINE PREPARATION
Spanishtranilcipromina
Parent ConceptsPropylamines (C0033504), Monoamine Oxidase Inhibitors (C0026457), [CN602] MONOAMINE OXIDASE INHIBITOR ANTIDEPRESSANTS (C0973505), Monoamine oxidase A inhibitor (C1629501), Monoamine Oxidase (Type A) Inhibitors (C1579359)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Nardil (C0701388)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD010624
EnglishNardil, Parke Davis Brand of Phenelzine Sulfate, Pfizer Brand of Phenelzine Sulfate, United Drug Brand of Phenelzine Sulfate
SourcesAOD, MSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Parnate (C0701426)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD014191
EnglishAllphar Brand of Tranylcypromine Sulfate, GlaxoSmithKline Brand of Tranylcypromine Sulfate, Goldshield Brand of Tranylcypromine Sulfate, Link Brand of Tranylcypromine Sulfate, Parnate, SmithKline Brand of Tranylcypromine Sulfate
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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