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Tranylcypromine (PARNATE)

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. 

tranylcypromine PARNATE mnemonic by Dr Jason Cafer MD

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.

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