TaperCommunityphenelzine
Boxed Warning
Suicidality risk in children, adolescents, and young adults under 25 during initial antidepressant treatment.
Phenelzine is a non-selective irreversible monoamine oxidase inhibitor (MAOI). Effective for atypical depression, treatment-resistant depression, and panic — but rarely used today because of strict dietary restrictions and dangerous drug interactions.
15mg tablets
Tablets: 15mg
Category C
Irreversibly binds and inactivates MAO-A and MAO-B, blocking the breakdown of serotonin, norepinephrine, dopamine, and tyramine.
Very slow taper required. Even after the last dose, MAO inhibition persists for ~2 weeks. Do NOT switch directly to another antidepressant — full 14-day washout required.
MAOIs are the hardest antidepressants to discontinue safely. Plan washout windows carefully when transitioning to or from any other agent.
1-5 days after stopping
1-3 weeks
4-8 weeks (MAO enzyme regeneration takes ~2 weeks)
Sleep architecture and mood reactivity can take 2-3 months to renormalize
Toxicity
Hypertensive crisis with tyramine-rich foods (aged cheese, cured meats, tap beer, fermented soy, broad beans). Serotonin syndrome with serotonergic agents. Significant overdose risk.
Pharmacokinetics
Hepatic.
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