Tranylcypromine
Irreversible, non-selective MAO inhibitor antidepressant for treatment-resistant depression.
Pharmacology
Contents
WHAT IS TRANYLCYPROMINE?
Detailed overview
Tranylcypromine (Parnate) is an irreversible, non-selective monoamine oxidase (MAO) inhibitor used mainly for treatment-resistant major depression after other antidepressants have failed. Its cyclopropylamine scaffold is amphetamine-like, so alongside sustained blockade of MAO-A and MAO-B it adds mild stimulant and norepinephrine-reuptake-inhibiting activity, raising serotonin, noradrenaline and dopamine together. The clinical effect builds over several weeks, and because the enzyme inhibition is irreversible, the effect persists 1-2 weeks after the drug itself has cleared. It is a potent, long-approved medicine that must be used only with a strict low-tyramine diet and careful attention to drug interactions.
Mechanism
Irreversible, non-selective MAO-A/B inhibitor
Onset
Several weeks; enzyme block lasts 1-2 weeks
Legal status
Prescription antidepressant (FDA/EMA)
Receptor profile
- MAO-A enzyme (irreversible)Strong
- MAO-B enzyme (irreversible)Strong
- Monoamine release / reuptake (amphetamine-like, weak)Weak
Safety
Side effects, stop signs, contraindications
Side effects · 5
- Orthostatic hypotension: dizziness, lightheadedness on standing, the most common dose-limiting complaint
- Insomnia and restlessness, especially with late-afternoon dosing (mild stimulant effect)
- Hypertensive crisis risk with tyramine-rich foods (aged cheese, cured meat, beer): severe headache, spiking blood pressure
- Serotonin syndrome risk when combined with SSRIs, SNRIs, triptans or other serotonergic agents
- Weight change, sexual dysfunction, dry mouth
Contraindications · 5
- Concurrent SSRIs/SNRIs/tricyclics or other MAO inhibitors: serotonin syndrome, a washout period is required
- Failure to follow a low-tyramine diet: hypertensive crisis, so strict dietary restriction is required
- Sympathomimetics (pseudoephedrine, amphetamines), cold remedies: blood-pressure crisis
- Pheochromocytoma, severe cardiovascular disease, cerebrovascular disease
- Pregnancy and breastfeeding: only after clear benefit-risk assessment under medical supervision
Related Nootropics
Same therapeutic category
Studies
Related research and clinical findings
Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report
McGrath PJ, Stewart JW, Fava M, et al.
Review and meta-analysis of add-on tranylcypromine with antipsychotic drugs for the treatment of schizophrenia with predominant negative symptoms: a restoration of evidence
et al.
Combination of Tranylcypromine and Mirtazapine in Difficult-to-Treat Depression
et al.
Tranylcypromine vs. lamotrigine in the treatment of refractory bipolar depression: a failed but clinically useful study
et al.
Sustained effects of phenelzine and tranylcypromine on orthostatic challenge in antidepressant-refractory depression
et al.
MAOIs - does the evidence warrant their resurrection?
et al.
FAQ
FAQ
Irreversible, non-selective MAO inhibitor antidepressant for treatment-resistant depression.
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Structure & chemistry
The information here is strictly for educational and scientific purposes. It does not replace medical advice or clinical consultation, and it does not encourage illegal substance or pharmaceutical use. Data is sourced. When in doubt, consult your doctor.