Phenelzine Sulfate and Hypotension

• Generic Name: phenelzine
• Dosage Forms: n.a.
• Other Brand Names: Nardil

Treatment of major depressive disorder.

Phenelzine is effective in patients with depression clinically characterized as atypical, nonendogenous, or neurotic; these patients often have mixed anxiety and depression and phobic or hypochondriacal features. Less conclusive evidence that drug is useful in severely depressed patients with endogenous features.

Because of potential for serious adverse effects and necessity of dietary restrictions, MAO inhibitors (e.g., phenelzine, tranylcypromine) generally are not used as initial therapy for major depressive disorder, but are reserved for carefully selected patients who can be closely supervised and who have depression refractory to other antidepressants (e.g., SSRIs, SNRIs, TCAs) or in whom other therapies are contraindicated.

Phenelzine has been used with some success in the management of bulimia nervosa.

However, MAO inhibitors are potentially dangerous (e.g., risk of hypertensive crisis) in patients with eating disorders and should be used with caution in patients with chaotic binge eating and purging behaviors. MAO inhibitors currently are not recommended as first-line therapy in the management of bulimia nervosa.