Sometimes, a single medication won't work for depression. If your doctor has tried several medications and your condition hasn't improved, the next step may be to try something like Phenelzine. But this is a very strong medication, and you need to be very careful. So let's talk about this clearly and simply.
What is Phenelzine (Nardil®)?
Simply put, Phenelzine is a medication used to treat depression. Doctors usually prescribe it to people who have not responded to other antidepressants.
This belongs to a class of drugs called MAOI (Monoamine Oxidase Inhibitor) . Although the name is a bit complicated, what it does is very simple. There are chemicals (neurotransmitters) in our brain that control our mood, happiness, and calmness. The main ones are dopamine, norepinephrine, and serotonin . A person with depression can have low levels of these chemicals. So what this Phenelzine drug does is increase the levels of those chemicals again and improve your mood.
Things you need to tell your doctor before starting medication
This medicine is not suitable for everyone. Therefore, it is very important to give your doctor a complete description of your health condition. If you have any of the conditions below, be sure to tell them about it.
| Your situation | Why should you inform? |
|---|---|
| If you have high blood pressure, heart disease, heart rhythm disorders, or stroke | This medication can affect blood pressure, so it can be dangerous for people with heart disease. |
| Frequent headaches or migraines | The doctor should be aware of this, as severe headaches can occur as a side effect of the medication. |
| Liver or kidney disease | Since medications are eliminated from the body through these organs, if their function is impaired, the effects of the medication may change. |
| Glaucoma condition | This medicine can affect eye pressure. |
| Other mental illnesses, suicidal thoughts, or previous attempts | This medication may increase such thoughts in some people in the early stages, so close monitoring is necessary. |
| If you drink alcohol frequently | The combination of alcohol and this medication can have dangerous consequences. |
| If you are pregnant, trying to get pregnant, or breastfeeding | You should talk to your doctor about whether the medication could affect your child. |
How exactly do you use this medicine?
The way you use this medicine is very important.
- Take this medicine with a glass of water.
- Take only the prescribed dose, when prescribed by your doctor. Never take more than the prescribed amount.
- The most important thing is that you do not suddenly stop taking this medication. If you do, your symptoms may worsen or you may experience other physical discomfort. If you do stop taking the medication, do so as directed by your doctor, gradually reducing the dosage.
- If you take too much medicine: If you suddenly think you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Department (ETU) of the nearest hospital. Do not delay.
- If you miss a dose: If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once.
This medicine is for you only. Do not give it to anyone else, even if they have the same symptoms as you.
Be careful! Do not use Phenelzine with these things!
This is the most important part of this article. Phenelzine can cause very dangerous reactions when combined with other medications, foods, and drinks.
Pay special attention to foods and drinks containing Tyramine!
While taking this medicine, you should completely avoid foods and drinks containing the amino acid Tyramine. If these two are combined, your blood pressure can suddenly rise to dangerous levels. We call this a Hypertensive Crisis . This can cause severe headaches, vomiting, stiff neck, sweating, and a rapid heartbeat.
Foods to avoid:
- Aged cheeses: Cheddar, blue cheese, Swiss, parmesan.
- Processed meats: Sausages, salami, pepperoni, bacon, etc. Smoked, aged, and salted meat and fish.
- Alcohol: especially red wine, some beers.
- Soy products: soy sauce, tofu (bean curd), miso soup.
- Some fruits and vegetables: very ripe bananas, avocados, raisins, broad beans (fava beans).
- Foods containing yeast (Yeast extracts): Like Marmite, Vegemite.
- Chocolate and drinks containing caffeine: coffee, tea, cola drinks.
Important: You should avoid these foods and drinks for two weeks after stopping this medication. Ask your doctor for specific advice.
Do not take Phenelzine with these medications!
The following medications can cause serious side effects when taken with this medicine. Be sure to tell your doctor if you are taking any of these.
- Other antidepressants and medications for mental illness
- Some medicines for colds, coughs, and allergies (decongestants)
- Diet pills
- Some painkillers (e.g. Tramadol, Meperidine)
- Migraine medication
- Dextromethorphan (found in many cough syrups)
- General or local anesthetics
This list is not complete. Therefore, tell your doctor about all the medications you are taking (including vitamins and herbal products) .
What side effects might I experience?
Like all medications, this one can have side effects. Some are normal, while others require immediate attention.
| Side effect | What to do? |
|---|---|
| Serious side effects that should be reported to the doctor immediately | |
| Severe high blood pressure: sudden, severe headache, vomiting, neck stiffness, rapid heartbeat, sweating. | Go to the nearest hospital's Emergency Department (ETU) immediately. |
| Allergic reactions: skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. | Seek medical advice immediately. |
| Mental changes: Increased suicidal thoughts, severe agitation, irritability, aggressive behavior. | Tell your doctor or a family member immediately. |
| Common side effects that should be reported to the doctor if they persist | |
| Dizziness, drowsiness | Avoid driving or operating machinery. |
| Dry mouth | Chewing sugar-free gum and drinking more water can help. |
| Insomnia, nausea, constipation | If these persist or are bothersome, tell your doctor. |
Take-Home Message
- Phenelzine is a very strong medication for depression. Therefore, follow your doctor's instructions exactly.
- Do not stop taking the medication suddenly for any reason without consulting your doctor.
- Avoid foods and drinks containing tyramine (such as aged cheese, processed meats, red wine) completely. This can cause very dangerous reactions.
- Tell your doctor about all other medications you are taking.
- If you experience any changes in your thoughts or behavior (especially suicidal thoughts) during the initial period of starting the medication , seek medical advice immediately.
- Avoid driving until you know how the medicine affects you, as dizziness and drowsiness may occur.
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