Tranylcypromine
Parnate
Monoamine Oxidase InhibitorGeneric availableTDM data
The mechanism of action of tranylcypromine tablets as an antidepressant is not fully understood, but is presumed to be linked to potentiation of monoamine neurotransmitter activity in the central nervous system (CNS) resulting from its irreversible inhibition of the enzyme monoamine oxidase (MAO).
Compare Tranylcypromine →FDA-Approved Indications
- Major depressive disorder — second-line after other antidepressants (adults)
Common Off-Label Uses
- Social anxiety disorder
- Panic disorder
- Treatment-resistant anxiety
What Sets This Drug Apart
- Irreversible non-selective MAOI structurally related to amphetamine — more activating and less sedating than phenelzine
- Preferred MAOI for depression with apathy, psychomotor retardation, and fatigue due to its activating pharmacology
- Very short half-life (2-3h) but irreversible MAO inhibition means clinical effect persists until new enzyme is synthesized (~2 weeks)
- Same strict dietary tyramine restrictions and 14-day serotonergic washout as phenelzine
- Insomnia (>30%), dry mouth (>30%), and dizziness (>30%) are the most frequent adverse reactions
- Lowest weight gain potential among classic MAOIs due to amphetamine-related structure
Boxed Warning
WARNING: SUICIDAL THOUGHTS AND BEHAVIORS and HYPERTENSIVE CRISIS WITH SIGNIFICANT TYRAMINE USE WARNING: SUICIDAL THOUGHTS AND BEHAVIORS and