Phenelzine (uses, risks & side effects)

In this blog post, we will talk about Phenelzine, an antidepressant from the MAOI group. Let’s see how it works, its most important characteristics, as well as its therapeutic indications.

What is Phenelzine?

This psychotropic drug belonging to the MAOI group is one of the first antidepressants.

Antidepressants are currently used worldwide to especially treat depression. This use has been increasing over the years, although initially only MAOIs (monoamine oxidase inhibitors) were used, the first antidepressants that were synthesized.

As we have seen, phenelzine is an antidepressant that belongs to the group of monoamine oxidase inhibitors (MAOIs). It is a non-selective MAOI, that is, it inhibits both type A and types B monoamine oxidases. Monoamine oxidases are enzymes that degrade neurotransmitters -amines (serotonin and norepinephrine).

Phenelzine is considered the first antidepressant available on the market. On the other hand, although MAOIs have been replaced by other more modern drugs in most cases, their pharmacological action makes them continue to be the most effective in the treatment of atypical depression, for example. It is also effective in those cases where other medications have not produced results, and in intense anxiety.

Phenelzine is marketed in the form of tablets to be taken by mouth.

Phenelzine – Mechanism of action

This antidepressant works by increasing the amount of certain natural substances that are necessary to maintain mental balance. Specifically, they act by blocking the action of the monoamine oxidase enzyme. 

Said enzyme breaks down serotonin and norepinephrine; being degraded, its action is interrupted, and therefore increases the amount of serotonin (SA) and norepinephrine (NA) in the brain. Both SA and NA have been directly related to depression; people with depression often have lower levels of these neurotransmitters.

Phenelzine – Therapeutic indications

Phenelzine is mainly used to treat depression in people who did not respond to other medications, such as in atypical depression (whose symptoms are hypersomnia, hypersensitivity, increased appetite, extreme tiredness, and marked anxiety).

On the other hand, it is also indicated for anxiety, bulimia and social phobia.

Phenelzine – Side effects

Some of the side or adverse effects of phenelzine are:

• Drowsiness (sleep).
• Weakness.
• Dizziness
• Dry mouth
• Constipation.
• Weight gain.
• Decreased sexual ability.
• Uncontrollable trembling of a part of the body.
• Stiffness or muscle spasms.
• Suicidal tendencies.

It should be noted that during the clinical studies of Phenelzine, a small number of children, adolescents, and young adults (up to 24 years of age) who took antidepressants such as phenelzine, had suicidal tendencies. These translated into thoughts like harming or killing yourself, planning to do it or trying.

These suicidal tendencies appeared both in phenelzine and in many other antidepressants.

However, experts do not know exactly what the risk of taking it is, or to what extent we should consider this probability of the appearance of suicidal tendencies in the case of a child or adolescent who must take antidepressants.

Therapeutic indications

Phenelzine controls the symptoms of depression but does not cure your disorder. It is used in most cases to treat depressive illness. It is also sometimes used to treat eating disorders, cocaine addiction, headaches, and panic attacks.

Pharmacokinetics

Phenelzine is administered orally as phenelzine sulfate and is rapidly absorbed through the gastrointestinal tract. Although its half-life is short, its effects remain in effect for weeks once it is stopped, until the body itself produces enough monoamine oxidase again. Phenelzine is metabolized in the liver and excreted in the urine.

Cautions

While the patient is taking phenelzine, avoid food and drinks containing tyramine or tryptophan and for at least 2 weeks after stopping this medication. These foods and beverages including alcoholic beverages, especially beer, and other red wines; alcohol-free beer; cheeses (especially strong, aged, or processed varieties).

Likewise, many drugs that react with phenelzine should be avoided, so the doctor will also provide the patient with a detailed list of such drugs. Another serious risk inherent in phenelzine is acute liver failure, which has been observed in patients with liver disease, the elderly, who have taken alcohol or certain contraindicated medications, or who have suffered from viral infections.

Contraindications

• Liver failure or impaired liver function tests, cerebrovascular diseases.
• Pheochromocytoma
• Not indicated in the manic phase

Issues to consider

Globally speaking, it can be mixed with any natural product such as naturopathy or homoeopathy. It can be taken on an empty stomach or with food.

Two weeks before you start taking it you must have stopped taking any other antidepressant drug (4 weeks if you are taking the antidepressant fluoxetine).

While taking this drug, nasal decongestants cannot be used.

While taking this drug it is necessary to avoid a series of foods (for example, certain sausages, certain cheeses and certain alcoholic beverages). This fact is not trivial since the simultaneous consumption of phenelzine and certain foods has a high risk of producing severe hypertensive crises.

Treatment of depression without medication

If you want to treat your depression without medication, then you have to know that this is possible. There are several alternatives to treat depression without any need for medication. With this, we are referring fundamentally to psychotherapy. Psychotherapy is a model of deep therapy that helps you structure your thoughts and find the pleasure of living again.

If you decide to choose this type of therapy, you will realize that as you progress in your personal therapy, there will be more and more things that you will feel and experience. Depression leaves us essentially numb, lethargic, and therefore it is as if our emotions disappear.

 If you decide to treat your depression resorting exclusively to therapy without medication, then you can step by step begin to feel again the pleasure of living and happiness.

In psychology, there is a general rule that people who do not have a form of genetic depression or more severe depression can perfectly treat their depression without resorting to medication. Therefore, a treatment without medication is mainly for people who:

• They suffer from depression for the first time.
• They have milder depression.
• Whose depression does not come from another mental illness.

Most people meet the criteria described above.

As we mentioned earlier in this article, psychotherapy is a good option as a treatment to fight depression. Various studies have shown that cognitive-behavioural therapy has proven to be one of the most effective types of therapy. 

In addition to the following therapy with a psychologist, there are also other types of therapy options today.

Depression can be approached psychotherapeutically by many methods. Mainly depression can be treated with short-term therapies, such as: cognitive therapy, interpersonal therapy, and behavioural therapy. Depending on the type of depression and the profile of the person with depression, psychoanalytic therapies, family therapies and other types may be recommended.

Why go to psychotherapy?

The effectiveness of psychotherapy in depression is widely recognized. Psychotherapy contributes both to improving the quality of life of patients and to reduce the total costs related to treatment by reducing the number of episodes.

Psychotherapy as the only method of treatment is an important strategy, applied to a relatively small group of patients with mild and moderate depression. It is an essential approach for patients who cannot take medication.

The combination of psychotherapy with antidepressant medication has been shown to have superior results for each approach taken separately. Psychotherapy increases the effect of antidepressant medication and is a factor that increases compliance with treatment.

Psychotherapy is not only effective in depression but can reduce costs by ameliorating the disability associated with depression and cognitive-behavioural therapy has been the most studied and has proven to be the most effective in depression. It is a structured method and generally consists of 12-16 sessions.

What is not psychotherapy?

When you go to a psychotherapist you should not expect a simple healing process but neither should a person give you advice. You can get advice from anyone – the internet is full of articles.

The purpose of psychotherapy is to help you figure out what the problems in your life are and how to act on them. Only you know what your priorities are and where you can make sacrifices. The therapist helps the patient to discover himself, and he will gain the courage to change what he does not like.

Therapy brings a deep understanding that can only come from the patient – if someone tells you what to do, you will not understand why and how to act in similar situations in the future. This intense personal experience is at the heart of every psychotherapeutic process.

In short, you go to psychotherapy to learn how to help yourself, you do not receive instructions, a specific plan of attack, which, if you follow it, you will do better in a very short time.

FAQ about Phenelzine

Conclusions

In this blog post, we talked about Phenelzine, an antidepressant from the MAOI group. We found out how it works, its most important characteristics, as well as its therapeutic indications.

This antidepressant works by increasing the amount of certain natural substances that are necessary to maintain mental balance. Specifically, they act by blocking the action of the monoamine oxidase enzyme. 

Phenelzine is considered the first antidepressant available on the market. On the other hand, although MAOIs have been replaced by other more modern drugs in most cases, their pharmacological action makes them continue to be the most effective in the treatment of atypical depression, for example. It is also effective in those cases where other medications have not produced results, and in intense anxiety.

If you have any questions or comments, please let us know!

References

Webmd.com – Phenelzine SULFATE

Medicines.org.uk – Nardil tablets

Drugs.com – Phenelzine

Medlineplus.gov – Phenelzine

Everydayhealth.com – What Is Phenelzine?