What are the side effects of phenelzine?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Depression can be addressed in patients through exercise, therapy and/or prescriptions. Antidepressants designed to treat these disorders are divided into different groups. These prescription groups are:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Monoamine oxidase inhibitors (MAOIs)
• Tricyclic antidepressants

Nardil (phenelzine) is an antidepressant medication in the MAOI group.

Misusing the medication or taking a different amount of Nardil than prescribed can lead to serious side effects. Since MAOIs affect brain chemistry, not following the doctor’s recommendations make it more likely for the patient to suffer severe side effects that can be life-threatening. On top of the normal side effect risks, misusing phenelzine can also result in hyperactivity, irregular pulse, difficulty breathing, hallucinations, unusual muscle contractions, seizures, hypertension, hypotension, fever, coma or death.

It is essential that you work with your doctor and follow their instructions closely while taking this MAOI to treat your depression. They are there to help you.

What Is Nardil (Phenelzine)?

Nardil is the brand name for the generic antidepressant phenelzine. As previously mentioned, the medication belongs to the MAOI group of antidepressants. These work by balancing the neurochemicals in the brain which are known to cause depression symptoms. Due to the way MAOIs operate, the neurochemical adjustments can cause unwanted side effects. This prescription is not recommended for people under 25, as it may increase suicidal thoughts.

Some side effects from taking phenelzine are weakness, dizziness, insomnia, dry mouth, gastrointestinal issues or impotence. There are more serious side effects that can occur and, if shown, you should contact your doctor immediately. These side effects to watch out for include:

• light-headedness
• agitation or unwanted changes in behavior
• rapid weight gain
• changes in heart rate or chest pain
• severe or sudden headaches
• stiffness in your neck
• vomiting
• sweating
• sensitivity to light or vision problems.

If you’re taking phenelzine, you need to follow a strict diet, as the medication can interact with certain foods containing tyramine. The interaction can cause a severe reaction that may be fatal, so check with your doctor about your dietary needs.
Due to the side effect risks of phenelzine, doctors will typically choose this medication only after other antidepressant medication types have been tried and failed.

Nardil (Phenelzine) Addiction

Although phenelzine isn’t listed specifically as an addictive prescription, it does affect chemicals in your brain. As with any medication that alters your body chemistry, stopping the treatment plan for an antidepressant can be tricky. To lessen the likelihood of withdrawal symptoms from Nardil, your doctor will gradually lower your dosage of the medication. It is never recommended to abruptly stop taking phenelzine or any other antidepressant. Work with your doctor to find the right pace to safely end the treatment plan.

Even though you will be working with your doctor and weaning off the medication slowly, you may still experience side effects from discontinuance. These may include:

1. flu-like symptoms
2. anxiety
3. agitation
4. insomnia
5. sweating
6. chills
7. nausea
8. headache

Nardil (Phenelzine) Long-Term Effects

Nardil is a prescription which is processed by the liver; therefore, extended long-term use can damage the liver and lead to cirrhosis. Talk to your doctor if you have any concerns about taking Nardil long-term, especially if you have had previous liver problems.

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern, however, that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs (SSRIs and others) showed that these drugs increase the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (ages 18–24) with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older.

The pooled analyses of placebo-controlled trials in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressant drugs in over 4400 patients. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 patients. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences (drug vs placebo), however, were relatively stable within age strata and across indications. These risk differences (drug-placebo difference in the number of cases of suicidality per 1000 patients treated) are provided in Table 1.

Table 1

No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide.

It is unknown whether the suicidality risk extends to longer-term use, i.e., beyond several months. However, there is substantial evidence from placebo-controlled maintenance trials in adults with depression that the use of antidepressants can delay the recurrence of depression.

All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases .

The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, there is concern that such symptoms may represent precursors to emerging suicidality.

Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms.

Families and caregivers of patients being treated with antidepressants for major depressive Disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers . Prescriptions for Nardil should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose.

Screening Patients For Bipolar Disorder

A major depressive episode may be the initial presentation of bipolar disorder. It is generally believed (though not established in controlled trials) that treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder. Whether any of the symptoms described above represent such a conversion is unknown.

However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that Nardil is not approved for use in treating bipolar depression.

It should be noted that NARDIL is not approved for use in treating any indications in the pediatric population.

The most serious reactions to NARDIL involve changes in blood pressure.

Hypertensive Crises

The most important reaction associated with NARDIL administration is the occurrence of hypertensive crises, which have sometimes been fatal.

These crises are characterized by some or all of the following symptoms: occipital headache which may radiate frontally, palpitation, neck stiffness or soreness, nausea, vomiting, sweating (sometimes with fever and sometimes with cold, clammy skin), dilated pupils, and photophobia. Either tachycardia or bradycardia may be present and can be associated with constricting chest pain.

NOTE

Intracranial bleeding has been reported in association with the increase in blood pressure.

Blood pressure should be observed frequently to detect evidence of any pressor response in all patients receiving NARDIL. Therapy should be discontinued immediately upon the occurrence of palpitation or frequent headaches during therapy.

Recommended Treatment In Hypertensive Crisis

If a hypertensive crisis occurs, NARDIL should be discontinued immediately and therapy to lower blood pressure should be instituted immediately. On the basis of present evidence, phentolamine is recommended. (The dosage reported for phentolamine is 5 mg intravenously.) Care should be taken to administer this drug slowly in order to avoid producing an excessive hypotensive effect. Fever should be managed by means of external cooling.

Warning To The Patient

All patients should be warned that the following foods, beverages, and medications must be avoided while taking NARDIL, and for two weeks after discontinuing use.

Foods And Beverages To Avoid

Meat and Fish

Pickled herring Liver

Dry sausage (including Genoa salami, hard salami, pepperoni, and Lebanon bologna)

Vegetables

Broad bean pods (fava bean pods)
Sauerkraut

Dairy Products

Cheese (cottage cheese and cream cheese are allowed)
Yogurt

Beverages

Beer and wine
Alcohol-free and reduced-alcohol beer and wine products

Miscellaneous

Yeast extract (including brewer's yeast in large quantities) Meat extract

Excessive amounts of chocolate and caffeine

Also, any spoiled or improperly refrigerated, handled, or stored protein-rich foods such as meats, fish, and dairy products, including foods that may have undergone protein changes by aging, pickling, fermentation, or smoking to improve flavor should be avoided.

OTC Medications To Avoid

Cold and cough preparations (including those containing dextromethorphan) Nasal decongestants (tablets, drops, or spray) Hay-fever medications Sinus medications Asthma inhalant medications Antiappetite medicines Weight-reducing preparations "Pep" pills

L-tryptophan containing preparations

Also, certain prescription drugs should be avoided. Therefore, patients under the care of another physician or dentist should inform him/her that they are taking NARDIL.

Patients should be warned that the use of the above foods, beverages, or medications may cause a reaction characterized by headache and other serious symptoms due to a rise in blood pressure, with the exception of dextromethorphan which may cause reactions similar to those seen with meperidine. Also, there has been a report of an interaction between NARDIL and dextromethorphan (ingested as a lozenge) causing drowsiness and bizarre behavior.

Patients should be instructed to report promptly the occurrence of headache or other unusual symptoms.

Concomitant Use With Dibenzazepine Derivative Drugs

If the decision is made to administer NARDIL concurrently with other antidepressant drugs, or within less than 10 days after discontinuation of antidepressant therapy, the patient should be cautioned by the physician regarding the possibility of adverse drug interaction.

A List Of Dibenzazepine Derivative Drugs By Generic Name Follows

nortriptyline hydrochloride amitriptyline hydrochloride perphenazine and amitriptyline hydrochloride clomipramine hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl

mirtazapine

NARDIL should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result.

Use in Pregnancy

The safe use of NARDIL during pregnancy or lactation has not been established. The potential benefit of this drug, if used during pregnancy, lactation, or in women of childbearing age, should be weighed against the possible hazard to the mother or fetus.

Doses of NARDIL in pregnant mice well exceeding the maximum recommended human dose have caused a significant decrease in the number of viable offspring per mouse. In addition, the growth of young dogs and rats has been retarded by doses exceeding the maximum human dose.