Tranylcypromine was released in 1961, the same year as phenelzine. Tranylcypromine has a short elimination half-life of 2.5 hours. The half-life is irrelevant, because inhibition of MAO is irreversible, and the effect continues for up to 2 weeks after the medication is discontinued.
Dietary tyramine restriction is necessary to avoid hypertensive crisis, as depicted in the isocarboxazid (Marplan) monograph.
Risk of serious outcome from a single-drug overdose of tranylcypromine is about 40%, which is one of the highest morbidity rate among antidepressants. There was 1 death out of 330 single-drug overdoses (Nelson & Spyker, 2017).
Dosing: Start: 10 mg TID; After 2 weeks may increase by 10 mg/day q 1–3 weeks; Max is 60 mg/day (20 mg TID); Taper gradually to stop.