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Re: Nardil update. Escapee

Posted by SLS on September 24, 2016, at 13:56:42

In reply to Re: Nardil update., posted by Escapee on September 24, 2016, at 11:37:00

It is Parnate (tranylcypromine) that has the 2-3 hour half-life. Parnate goes in, some of which attaches to the MAO enzyme irreversibly (almost). The rest of it is quickly eliminated from the blood stream, but the "damage" to the enzymes have already been done.

Nardil (phenelzine) is a weird one. Despite its having a 12 hour half-life, it builds up in the brain exponentially as the dosage is increased linearly. This is because Nardil inhibits its own metabolism. It is broken down by MAO. Since it inhibits MAO, the rate of metabolism decreases with increasing dosage. This is important to consider when dosing. The difference between 45 mg/day to 60 mg/day yields a greater percentage jump in drug activity than the difference between 30 mg/day and 45 mg/day. For this reason, it is good practice to make dosage increases at a minimum of 3 week intervals - one week to gain sufficiently more MAO inhibition, and two more weeks to respond to it.

It takes courage to go back on a drug that had forced you to use a catheter last time. That's not much fun - I know.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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