Talk:Isocarboxazid

This super-stub on marplan/isocarboxazid reflects mostly 'lore' long accepted but not supported by evidence (i.e. the unsupported assertion that other medications are 'safer'; one could easily find a citation independently asserting it, but said outside citation simply be an assertion. As it happens, the latest 200 patient study regarding tyramine reactions found none with isocarboxazid, and clinicians still familiar with it...never actually heard one mention it; it's long been known that the 'cheese reaction' is very prominently associated not with hydrazine MAOi antidepressants but with mechanistically similar (but not structurally) MAOi 'parnate'--which does contain substantial dietary risks (again, decades of experience have lead to a much-reduced list of dietary restrictions even there).

Further, and also unsubstantiated, this article mentions drug reactions, whereas (Bodkin, Cole 2006) note that in fact all tricyclic antidepressants but clomipramine appear safe in combination with isocarboxazid and its cousins, notwithstanding exactly one documented case involving a dose of parenteral trimipramine. There's also literature and a wealth of clinical evidence substantiating the proper use of stimulants in combination as well, to enhance the already superior AD effect of isocarboxazid, parnate, or phenelzine if at all adequately dosed, and as the second-line treatment to combat their primary side-effect of moderate orthostatic hypertension (after NaCL): 2.5-5mg d-amphetamine, increasing until normal diastolic BP is maintained.

In short, this stub is perhaps 35 years out of date, not reflecting the experience demonstrating the many ways clinicians familiar with the medications are well aware previous dangers were greatly exaggerated; the article is further remiss in not mentioning superior efficacy data, nor in adequately warning of isocarboxazid's rather more serious danger to the human liver. In short, heavy rewriting is needed by someone who knows the medication and is not given to throwing around loose 'conventional wisdom' which is, at the very least, undemonstrated, if not entirely false. Who wrote this article, then, and why are there so many incorrect AND unsubstantiated assertions? Why is are the actual medical concerns (hepatic) inadequately mentioned? This sort of writing can help no one, and is fundamentally disinformative and unacceptable here.2604:2000:6B15:C300:14A0:AD26:555A:AB25 (talk) 03:05, 23 September 2016 (UTC)