iPsychology

Tranylcypromine ( Parnate )

Tranylcypromine ( Parnate ) is for the treatment of major depressive episode without melancholia.

• Not a first line of therapy; is used when clients have failed to respond to other drug therapy.
• Investigational: Alone or as an adjunct to treat bulimia, obsessive compulsive disorder, and manifestations of psychotic disorders.
• Treatment of social phobia, seasonal affective disorders, adjunct to treat multiple sclerosis, and to treat idiopathic orthostatic hypotension refractory to conventional therapy.
  

Strengths:
Tablets: 10 mg.

Normal dosage:
If under 18 years of age, DO NOT USE.

• 18 to 60 years of age, 30 mg daily.
• Over 60 years of age, lower dosage, increased cautiously.
• Dosages: Actual dosage must be determined by a physician.

Dosage Depends on Disorder:

• Major depressive syndrome without melancholia.
  Start : 10 mg 3 times daily.
  Increase: 10 mg after 2 weeks.
  Maximum : 60 mg in 24 hours.
  

Problems with:
Liver Function: N/A
Kidney Function: N/A.

Testing:
Before taking: None if for short-term use.
While taking: None if for short-term use.

Take: Take each dose with a full glass of water.

Full Benefits: First day to a week.

Missed Dose(s): Take if within one hour, if over an hour skip and then continue on your normal schedule. Never Take a Double Dose

To Stop Use: Do not stop without consulting your physician.

Overdose symptoms include: Insomnia, restlessness, anxiety, agitation, mental confusion, incoherence, hypotension, dizziness, weakness, drowsiness, shock, hypertension with severe headache. Rarely, hypertension accompanied by twitching or myoclonic fibrillation of skeletal muscles with hyperprexia, generalized rigidity, and coma.

Warnings

Do not drink alcohol when taking benzodiazepines.

Do not take this drug if you are pregnant. Do not take this drug if planning to become pregnant.

D o not take if you are breast-feeding.

Do not use if:

• you had negative reactions to other benzodiazepines in the past.
• you have a history of drug dependence.
• you have had a stroke.
• you have multiple sclerosis.
• if you have Alzheimer's disease.
• if you are seriously depressed or if you have other brain disorders.

Tranylcypromine ( Parnate ) Symptoms or Effects

Common: Anxiety, agitation, headaches ( without elevation of BP ), manic symptoms, restlessness, insomnia, weakness, drowsiness, dizziness, significant anorexia. dry mouth, nausea, diarrhea, abdominal pain, constipation. tachycardia, edema, palpitation.
Impotence, urinary retention, impaired ejaculation, muscle spasm, tremors, myoclonic jerks, numbness, paresthesia, hnemia, leukopenia, agranulocytosis, thrombocytopenia, blurred vision, chills, impotence, hepatitis, skin rash, impaired water excretion, and / or tinnitus.

Tranylcypromine ( Parnate ) Drug Interactions

• Alcohol - Possibility of excitation, seizures, delirium, hyperpyrexia, circulatory collapse, coma, death.
• Anesthetics, general - Hypotensive effect.
• Antidepressants, tricyclic - Concomitant use excitation, sweating, tachycardia, tachypnea, hyperpyrexia, disseminated intravascular coagulation, delirium, tremors, convulsions, death.
• Antihypertensive drugs - Exaggerated hypotensive effects.
• Beta-adrenergic blocking drugs - Exaggerated hypotensive effects.
• Buspirone - Elevated BP
• Dextromethorphan - Brief episodes of psychosis or bizarre behavior
• Ephedra.
• Fluoxetine - Possibility of hyperthermia, rigidity, myoclonic movements, death.
• Ginseng - Risk of headache, mania, or tremor.
• MAO Inhibitors - Concomitant use of tranylcypromine with other MAO inhibitors may cause a hypertensive crisis or severe seizures. Discontinue the MAO inhibitor at least 7-10 days before initiating a new drug. However, such combinations have been used together successfully.
• Meperidine.
• Narcotics - Possibility of excitation, seizures, delirium, hyperpyrexia, circulatory collapse, coma, death.
• St. John's wort - Do not use with tranylcypromine.
• Scotch broom herb - Risk of hypertensive crisis.
• Selective serotonin reuptake inhibitors ( SSRI's ).
• Sympathomimetic drugs - amphetamine, cocaine, dopa, ephedrine, epinephrine, metaraminol, methyldopa, methylphenidate, norepinephrine, phenylephrine, phenylpropanolamine.
• Many OTC cold products, hay fever medications, and nasal decongestants.
• Thiazide diuretics - Exaggerated hypotensive effects.
• Tryptophan - Possibility of behavioral and neurologic effects, including disorientation, confusion, amnesia, delirium, agitation, hypomania, ataxia, myoclonus, hyperreflexia, shivering, ocular oscillation,and Babinski signs.
• Tyramine rich foods - beer, broad beans, certain cheeses ( Brie, cheddar, Camembert, Stilton) , Chianti wine, chicken livers, caffeine, cola beverages, figs, licorice, liver, pickled or kippered herring dry sausage ( Genoa salami, hard salami, pepperoni, Lebanon bologna ), tea, cream, yogurt, yeast extract, and chocolate.