Tranylcypromine Amitriptyline

There are four classes of antidepressants tricyclic antidepressants (imipramine, trimipramine, amitriptyline, doxepin, desipramine, protriptyline, nortriptyline, amoxapine, maprotiline) monoaminooxidase (MAO) inhibitors (phenelzine, isocarboxazid, tranylcypromine) second-generation antidepressants or atypical antidepressants, which are a chemically dissimilar group of recently proposed drugs (bupropion, trazodone, fluoxetine) and amphetamines and other stimulators of the CNS (dextroamphetamine, methylphenidate). 

OFFICIAL NAMES Amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), fluoxetine (Prozac), imipramine (Norfranil, Tofranil), isocarboxazid (Marplan), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Aventyl, Pamelor), paroxetine (Paxil), phenelzine (Nardil), protriptyline (Vivactil), sertraline (Zoloft), thioridazine (Mellaril), tranylcypromine (Parnate), trazodone (Desyrel), trimipramine (Sur-montil), venlafaxine (Effexor) the herb St. John s wort (Hypericum perforatum) is sold over-the-counter without prescription STREET NAMES Happy pills... 

Anafranil (clomipramine) Asendin (amoxapine)4 Elavil (amitriptyline) Norpramin (desipramine) Pamelor (nortriptyline) Parnate (tranylcypromine)5 Sinequan (doxepin) Surmontil (trimipramine) Tofranil (imipramine) Vivactil (protriptyline)... 

Razani J, White KL, White J, Simpson G, Sloane RB, Rebal R, Palmer R. The safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatment. A controlled trial. Arch Gen Psychiatry 1983 40(6) 657-61. 

Antidepressants MAO-I (e.g., isocarboxazid, phenelzine, tranylcypromine) Tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline, etc.)... 

Clinically important, potentially hazardous interactions with albuterol, alpha-blockers, amitriptyline, amoxapine, atenolol, beta-blockers, carteolol, chlorpromazine, clomipramine, cocaine, desipramine, doxepin, ephedra, ergotamine, furazolidone, halothane, imipramine, insulin detemir, MAO inhibitors, metoprolol, nadolol, nortriptyline, oxprenolol, penbutolol, phenelzine, phenoxybenzamine, phenylephrine, pindolol, prazosin, propranolol, protriptyline, sympathomimetics, terbutaline, thioridazine, timolol, tranylcypromine, tricyclic antidepressants, trimipramine, vasopressors... 

Clinically important, potentially hazardous interactions with amitriptyline, amphetamines, aprepitant, astemizole, clarithromycin, dexibuprofen, dextroamphetamine, diethylpropion, digitalis, digoxin, duloxetine, erythromycin, isocarboxazid, linezolid, MAO inhibitors, mazindol, methamphetamine, molindone, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, pseudoephedrine, risperidone, selegiline, sibutramine, St John s wort, sumatriptan, sympathomimetics, tranylcypromine, trazodone, troleandomycin... 

MAOIs phenelzine, tranylcypromine TCAs amitriptyline, imipramine, clomipramine... 

DA agonists levodopa, bromocriptine, ropinirole, pramipexole, selegiline AAAD inhibitor carbidopa M-blockers benztropine, trihexiphenidyl MAOIs phenelzine, tranylcypromine TCAs amitriptyline, imipramine, clomipramine SSRIs fluoxetine, paroxetine, sertraline Others bupropion, mirtazapine, nefazodone, trazodone... 

Antidepressants are divided into the following classes the dibenzapine derivatives are called tricyclic antidepressants and include imipramine (Tofranil), desipramine (Norpramin), amitriptyline (Elavil), nortriptyline (Aventyl), protriptyline (Vivactil), and doxepin (Adapin). The monoamine oxidase inhibitors are nsed occasionally to treat depression. The hydrazine derivatives consist of isocarboxazid (Marplan) and phenelzine sulfate (Nardil). The nonhydrazine derivatives inclnde tranylcypromine (Parnate). L-Tryptophan is the only member of the monoamine precnrsors nsed to treat depression. The newer and second-generation antidepressants inclnde amoxapine, doxepin, flnoxetine, maprotiline, trazodone, mianserin, alprazolam, and bnpropion (see also Tables 5 throngh 7). 

Extracted amitriptyline, benztropine, brompheniramine, chlorpheniramine, chlorproma-zine, clomipramine, ( roheptadine, desipramine, diphenhydramine, dothiepin, doxepin, haloperidol, imipramine, loxapine, maprotiline, meperidine, mesoridazine, methadone, metoclopramide, mianserin, moclobemide, nomifensine, nordoxepin, norfluoxetine, nor-propo q)hene, northiaden, nortriptyline, pentoharhital, pheniramine, promethazine, propoxyphene, propranolol, protriptyline, quinidine, quinine, sulforidazine, thioridazine, thiothixene, tranylcypromine, treizodone, trihe q)henidyl, trimipramine, triprolidine Noninterfering dextromethorphan, norphetidine, phenoxyhenzamine, prochlorperazine, trifluoperazine Interfering amoxapine... 

Noninterfering amitriptyline, atenolol, bupropion, carbamazepine, chlordiazepoxide, ci-talopram, clomipramine, clozapine, cyclobenzaprine, doxepin, imipramine, loxapine, me-toprolol, mianserin, moclobemide, nomifensine, pindolol, thioridazine, tranylcypromine, trazodone, trimipramine... 

In contrast, there are a number of other uncontrolled studies and reviews describing the beneficial use of an MAOI with a tricyclic antidepressant. In addition, one study has reported switching 178 patients from tricyclics to MAOIs within 4 days or less. Of these patients, 63 were given the MAOI while still being tapered from the tricyclic, all without any apparent problems. Nevertheless, in a 6-week randomised doubleblind trial, the combinations of phenelzine or isocarboxazid plus trimi-pramine were less effective than trimipramine alone in patients with mild to moderate depression. Similarly, in a smaller randomised open study, the combination of amitriptyline and tranylcypromine was no more effective than either drug alone. ... 

Tranylcypromine, phenelzine, clomipramine and imipramine appear to be high on the list of drugs that have interacted adversely. Combination of clomipramine with tranyleypromine is particularly dangerous. Amitriptyline, trimipramine and isocarboxazid are possibly safer. 

Metabolic inactivation, whether taking place in the e,r, or at other sites, is often accidentally inhibited by other drugs. Thus many patients have died as a result of the simultaneous administration of an inhibitor of monoamine oxidase (an enzyme present in mitochondria) and an amine drug which is not toxic on its own. These monoamine oxidase inhibitors, such as tranylcypromine 9,47), are prescribed as mood-elevators in depressive illnesses. Until their synergistic properties were realized, they caused many deaths after usually safe doses of amphetamine, pethidine, and amitriptyline, or after the patient had consumed food rich in pressor amines such as tyramine such foods are red wine, meat-extract, yeast-extract, broad beans, and particularly cheese. These are examples of unfortunate synergism, but many favourable cases are known, examples of which will now be given. 

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