Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Phenelzine(click to collapse)
1/4 selected
Phenelzine
Nardil
Monoamine Oxidase Inhibitor
FDA-approved indications
- Atypical/nonendogenous/neurotic depression with mixed anxiety, phobic, or hypochondriacal features (adults; second-line)
Off-label uses
- Social anxiety disorder
- Panic disorder
- PTSD
Half-life11.6 hours
Decision GuideWhen to pick each / when to consider an alternative
Phenelzine
Consider when
- Atypical depression — strongest MAOI evidence for mood reactivity, hypersomnia, hyperphagia, leaden paralysis, rejection sensitivity
- Social anxiety disorder with phobic features — largest pharmacotherapy effect size for SAD (OR 3.37 in Williams 2020 NMA)
- Anxiety-predominant depression — unique GABA-T inhibition elevates GABA; enhanced anxiolytic effect vs other MAOIs
- Insomnia or agitation with depression — sedating profile benefits sleep vs tranylcypromine's activating effect
- +1 more
Consider an alternative when
- Tyramine-restricted diet adherence unlikely — boxed hypertensive crisis warning; full dietary restriction required at all doses
- Hepatic disease or alcohol use — hydrazine-derived hepatotoxicity; rare fatal progressive hepatocellular necrosis reported
- Weight gain is unacceptable — most weight gain among MAOIs (+++ Maudsley); more than tranylcypromine or selegiline
- Pyridoxine (B6) deficiency risk — unique to phenelzine as hydrazine derivative; lowers pyridoxal phosphate causing peripheral neuropathy
- +1 more
| Axis | Phenelzine MAOI |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Hypertensive crisis (tyramine/MAOI) | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Seizure risk | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
Sweating | |
| Cardiac | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Overdose toxicity | |