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Chemical Name: Tranylcypromine Sulfate Brand Name: Parnate Manufacturer: SmithKline Beecham Description: Mechanism of action unknown. An MAO inhibitor that probably promotes accumulation of neurotransmitters by inhibiting MAO. Indication and Use: Parnate is used in the treatment of major depression without melancholia. It should rarely be used as first line treatment and is more suited for patients who have failed to respond to more commonly prescribed antidepressants. Contraindications, Warnings, and Precautions: Contraindicated in patients receiving MAO inhibitors or dibenzazepine derivatives; sympathomimetics (including amphetamines); some CNS depressants (including narcotics and alcohol); antihypertensives, diuretics, antihistamines, sedatives or anesthetic drugs; bupropion hydrochloride, dextromethorphan, meperidine; cheese or other foods with a high tyramine or trypophan content; or excessive quantities of caffeine. Also contraindicated in patients with a confirmed or suspected cerebrovascular defect, pheochromocytoma, heart failure, cardiovascular disease, hypertension, hepatic disease, significant renal impairment, or history of headache, and in those undergoing elective surgery. Do not give with dizenzazepine-related entities since hypertensive crises or severe convulsive seizures have occurred in patients receiving such combinations. Do not administer with or within 14 days of Wellbutrin, Demerol, SSRI's, or Buspar. Allow a 5 week wash out of Prozac before starting Parnate. Hypertensive crises have sometimes been fatal and may be characterized by the following symptoms: occipital headache, neck stiffness or soreness, nausea or vomiting, sweating and photophobia. Intracranial bleeding, which can be fatal, has been reported in association with the paradoxical increase in blood pressure. Foods with a high tyramine content may cause a hypertnesive crisis. In general, avoid protein foods in which aging or protein breakdown is used to increase flavor, such as cheese, sour cream, Chianti wine, sherry, beer (including non-alcoholic), liquors, pickled herring, anchovies, caviar, liver, canned figs, dried fruits, bananas, raspberries, avocadoes, overripe fruit, chocolate, soy sauce, sauerkraut, fava beans, yeast extracts, yogurt, meat extracts or meats prepared with tenderizers. Adverse Reactions: Possible side effects may include dizziness, headache, vertigo, orthostatic hypotension, tachycardia, anorexia, leukopenia, and edema. Possible life threatening side effects include agranulocytosis and thrombocytopenia. Dosing Range: In adults, the usual effective dose is 10 mg three times a day. It may be increased by 10 mg daily at 1 to 3 week intervals to maximum of 60 mg daily, if there are no signs of improvement after a reasonable period.
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These pages are solely for public informational purposes. The information cannot be relied on to make diagnoses or prescribe treatment in any individual. Persons who require such services should consult with a licensed professional. Send mail to ropa@redoakpsychiatry.com with questions or comments about this web site.© 2000 Red Oak Psychiatry Associates, P.A. Updated
11/26/2007
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