Difference between revisions of "Tranylcypromine-fenelzine"
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| − | *Decrease tranylcypromine with 10 mg every 2 weeks. | + | *Decrease tranylcypromine with 10 mg every 2 weeks. |
| + | {{14dWashout}}<ref>van den Eynde et al. The prescriber’s guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression CNS Spectr 2023;28(4):427-440. doi: 10.1017/S1092852922000906.</ref> | ||
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| + | *A washout period of 14 days is necessary | ||
{{Startfenel}} | {{Startfenel}} | ||
| caveat = | | caveat = | ||
{{caveSS}} | {{caveSS}} | ||
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Latest revision as of 16:56, 14 April 2026
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Switch medication from tranylcypromine to fenelzine[1][2]
Stop tranylcypromine - Decrease tranylcypromine with 10 mg every 2 weeks.
- Stop and wait 14 days for washout[3]
Start fenelzine- A washout period of 14 days is necessary
- Start fenelzine in a low dosage of 15 mg, 3 times a day, for two weeks.
- After this two weeks the dosage of fenelzine can be increased.
Cave- Occurrence of the serotonin syndrome is possible without wash-out period.
- Tranylcypromine and fenelzine are irreversible MAO inhibitors for MAO-A and MAO-B. Fenelzine has higher affinity for MAO-A, whereas tranylcypromine has higher affinity for MAO-B. Side effects could occur during a switch. In addition, monitoring of sodium levels is adviced.[4]
- Known side effect for tranylcypromine are sleeping problems, agitation and orthostatic hypotension.
- Known side effects in fenelzine are oedema and/or increased liver enzyme levels.
- It is adviced to admit the patient in a mental health care clinic for intensive monitoring during this switch.[5]
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ van den Eynde et al. The prescriber’s guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression CNS Spectr 2023;28(4):427-440. doi: 10.1017/S1092852922000906.
- ↑ A van Diepen et al. De lange mars van farma naar patiënt Medisch Contact May 2021
- ↑ van den Eynde et al. Richtlijn voor het gebruik van klassieke MAO-remmers Psyfar 2023 nr 2
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