Phenelzine Sulfate(fen’ el zeen)
Nardil
PREGNANCY CATEGORY C
Drug Classes
Antidepressant
MAOI
Therapeutic Actions
Irreversibly inhibits MAO, an enzyme that breaks down biogenic amines, such as epinephrine, norepinephrine, and serotonin, thus allowing these biogenic amines to accumulate in neuronal storage sites. According to the biogenic amine hypothesis, this accumulation of amines is responsible for the clinical efficacy of MAOIs as antidepressants.
Indications
Treatment of patients with depression characterized as atypical, nonendogenous, or neurotic; patients who are unresponsive to other antidepressive therapy; and patients in whom other antidepressive therapy is contraindicated
Unlabeled uses: Treatment of bulimia, PTSD, chronic migraine not responsive to standard treatment, social anxiety disorders, migraine prophylaxis
Contraindications and Cautions
Contraindicated with hypersensitivity to any MAOI, pheochromocytoma, HF, history of liver disease or abnormal LFTs, severe renal impairment, confirmed or suspected cerebrovascular defect, CV disease, hypertension, history of headache, suicidal ideation.
Use cautiously with seizure disorders; hyperthyroidism; impaired hepatic, renal function; psychiatric patients (agitated or schizophrenic patients may show excessive stimulation; bipolar patients may shift to hypomanic or manic phase); patients scheduled for elective surgery; alcoholism; pregnancy, lactation.
Available Forms
Tablets—15 mg
Dosages
Adults
Initially, 15 mg PO tid. Increase dosage to at least 60 mg/day at a rapid pace consistent with patient tolerance. Many patients require therapy at 60 mg/day for at least 4 wk before response. Some patients may require 90 mg/day. After maximum benefit is achieved, reduce dosage slowly over several weeks. Maintenance may be 15 mg/day or every other day.
Pediatric patients younger than 16 yr
Not recommended.
Geriatric patients
Elderly patients are more prone to develop adverse effects; adjust dosage accordingly.
Pharmacokinetics
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Metabolism: Hepatic; T1/2: 12 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Urine
