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Tranylcypromine to Phenelzine?

Posted by MrChips on June 10, 2016, at 9:20:04

I'm considering switching from Tranylcypromine to Phenelzine. I'm wondering if anyone has any advice on this, in particular if anyone had similar problems to me with tranylcypromine and found phenelzine better or worse.

Problems with tranylcypromine:

Has become less effective over time (was never a miracle but it was good for the first few months).

Fine line between helping depression and causing anxiety. 40mg helps but 50mg causes increasingly severe anxiety a couple of weeks after upping the dose. This makes me think it is due to mao inhibition rather than its stimulant properties. Anyway, I can't increase it because of this.

Blood pressure increases after a dose - I take it with propranolol which helps but BP can still randomly go up to 180/100 from taking just 20mg (with a slow pulse, sweating, chest tightness). Usually it does not go so high but this is another reason to discontinue it.

Other side effects: severe brain fog, visual trailing - can't find any reference to this but it's definitely the tranylcypromine or an interaction between it and propranolol or pregabalin.


Did anyone actually have less side effects from Phenelzine (especially brain fog)?

Is there some "quality" of mao inhibition - like most ssri's all feel kind of similar (to me), do maoi's share certain features with each other (like brain fog or apathy etc) or are tranylcypromine and phenelzine subjectively very different?

Is it just me or is tranylcypromine really difficult to stop taking? I only need to miss one dose and I get brain zaps and feel really bad. Any advice on switching between maois?

I had success with sertraline+amitriptyline in the past but could not tolerate the amitriptyline for long (palpitations) so I'm also considering venlafaxine or maybe sertraline+nortriptyline. I just need something that is likely to be effective (pretty quickly and with minimal cognitive impairment) for depression and social anxiety.

Thanks...


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poster:MrChips thread:1089521
URL: http://www.dr-bob.org/babble/20160609/msgs/1089521.html