Talk:Phenelzine

David Foster Wallace
Withdrawal symptoms from nardil led to his suicide —Preceding unsigned comment added by 24.137.90.244 (talk) 09:41, 17 November 2008 (UTC)
 * Not according to the Rolling Stone piece referenced in the article. He went off Nardil (after years on it), got depressed again; went back on it but it no longer worked as before.--Straw Cat (talk) 19:54, 28 February 2010 (UTC)
 * I have just read in Suzanne Scanlon’s 2024 memoir Committed that Nardil was changed by Pfizer in 2003. Not the molecule itself, but the pill’s coating and other ingredients.  It was less resistant to stomach acid, so less may have been absorbed, she speculated, and wondered if David Foster Wallace had had the same experience.  The two had even met, she wrote, and discussed Nardil.  I considered adding this to the Nardil article but preferred to check with those coming before me. EdirolUA25 (talk) 03:13, 10 June 2024 (UTC)

The original Nardil?
Why isn't another company making the original Nardil? The action of phenelzine today is the same as it was when I first started taking it about 1985. At that time phenelzine was thought to be a dangerous drug that could raise the blood pressure and cause strokes. Phenelzine does cause a mild increase in dopamine and its first break down product, nor-epinephrine. We used nor-epinephrine for the treatment of shock when it first became available. The vaso-constrictor effect of nor-epinephrine may be the reason why phenelzine is so effective in treatment and prevention of migraine type headaches. However, not enough hypertensive action of nor-epinephrine occurs in blood pressure readings when given orally to cause the slightest increase in blood pressure. This year I am taking an ACE inhibitor that lowers the blood pressure very successfully and the phenelzine has no apparent effect on blood pressure. The primary action of phenelzine is, as suggested, obviously to prevent the destruction of enkephalins. Since I have taken phenelzine 30 mg. od my headaches have completely stopped. I can stand extreme pain without passing out. Taken orally it passes through blood brain barrier in ten minutes and stops the vomiting of migraine headaches that fast. I have used this drug for itching in my mother and kept her alive with it for an additional five years. Finally, the action of nor-epinephrine not only increases attention slightly, it improves steadiness of writing and reduces appetite. It has a great future for it if people are allowed to use it for reducing weight. Thomas Lee Tayor, MD (retired) 116 Jones Drive, Dunn, NC 28334-2911. tltaylor@dockpoint.net.


 * Dr.Tayor, I would simply advise you to revise your knowledge about Phenelzine as what you wrote has many inaccuracies, the biggest being related to the possible and quite real hypertensive crisis. Those are related to Tyramine not being metabolized by the enzyme MAO (MAO-A & MAO-B, which Phenelzine inhibit. The second biggest one is about it being possibly used in weight reduction: Phenelzine is one of the worst antidepressant in that regard, inducing acute carbohydrate cravings. To finish, Phenelzine isn't known to have any interaction with enkephalins, directly or indirectly.
 * I can't believe nobody corrected you. I think you may be a troll which use Dr.Thomas Lee Tayor name. "Origin Of English Genius" ? I mean, really?  For anyone who wants a good laugh, google this book name and go read the description!  --WhereIsMarty (talk) 08:45, 31 August 2009 (UTC)


 * Either this guy is a troll or he's just yet another really stupid doctor. If it's the latter, which I really hope it isn't, I'm glad to see him retired. Anyway, I've taken the "new" Nardil myself and found it to be quite a powerful drug. I think all the hype about the new formulation reducing its effectiveness is utter bullocks. I believe I remember seeing something about that in this Wiki article a long time ago, but apparently somebody has removed it since, and rightfully so if you ask me. El3ctr0nika (talk) 09:03, 1 September 2009 (UTC)


 * RE: Dr. Taylor's comments: Use of phenelzine in migraine prophylaxis is not common but is practised and yes I have seen 30mg per day prescribed for this purpose. However I'm concerned regarding your advice on blood pressure and phenelzine. The matter is not so much that phenelzine in itself affects blood pressure, although it can do, but rather the possibility of hypertensive crisis resulting from interaction between phenelzine and other drugs/foods. The chances of a hypertensive up-shot are less common than, for example, an anaphylactic shock (not that you would have such a reaction in this case but I'm drawing the analogy to illustrate probability) however they do occur and the prognosis following such a crisis is very worrying, cerebrovascular emergency following from hemorrhage due to intense increase in the pressure. The risk of such a crisis may be minimal by the dietary and living standards of a patient who foregoes what is on the list of restricted chemicals however the nature of phenelzine being prescribed in the first place would lead the doctor to be particularly wary that such a case might already be using drugs or alcohol that would increase the likelihood of a hypertensive occurance. Your advice on weight loss is the exact opposite of the case at hand. Phenelzine causes weight gain and not weight loss, it can cause weight loss in a very small number of cases however I've never seen one and any assertion that the drug aids weight loss is, to be honest, false. Thedaveformula (talk) 12:14, 25 November 2011 (UTC)

Along with Tyramine and certain medications increasing the risk of a hypertensive crisis, I believe from personal experience that a concurrent surge of adrenaline further increases that risk, although I've never seen any clinical investigation which supports that hypothesis. Since the use of MAOIs has been significantly declining over the past 20 years or so, there may be little motivation to actually research that theory. Shiba Inu (talk) 05:21, 15 December 2017 (UTC)

Nardil formulation
Nardil was changed in late 2003, due to a complete reformulation by Pfizer, which removed many of the excipient ingredients including the hard coating. It is possible that the current version is not surviving the stomach acid content and therefore not as much is being absorbed into the bloodstream. It is also possible that the machinery used to mix and manufacture Nardil is, since Pfizer acquired the medication, not able to sufficiently blend and mix the medication, making parts or all of some lots irregular in the content of medication delivered to the system.

Many users continue to experience difficulties following this change. The indicated dosage has not been altered by Pfizer, nor did they advise physicians or pharmacies of these changes, yet the recommended dosage seems not to have the desired effect on many. It is believed that, currently, there are some 75,000 to 85,000 people taking Nardil worldwide. The original formulation of Nardil is no longer available. It is now produced by Concord Pharmaceuticals in the UK.

Uses
Phenelzine is used primarily in the treatment of major depressive disorder. Patients with depressive symptomology characterized as "atypical," "nonendogenous," or "neurotic" have been reported to respond particularly well to phenelzine. The medication has also been found to be useful in patients who do not respond favorably to first and second-line treatments for depression. In addition to being a recognized treatment for major depressive disorder, studies have found phenelzine to be effective in treating dysthymia, bipolar depression , panic disorder , social anxiety disorder , bulimia , and posttraumatic stress disorder. Delphic110 (talk) 07:45, 9 June 2009 (UTC)

Copied to article section Delphic110 (talk) 08:28, 9 June 2009 (UTC)

Phenethylamine having overt psychoactive effects.
I notice that it says in the first section in body of the article that phenethylamine's amphetamine like action is essentially refuted.

My only issue with this is that MAO-B inhibitors (selegiline, Parnate, Nardil afaik) do in fact enable phenethylamine to have consistent psychoactivity and all relevant information regarding this should be provided.

Many people accidentally ingest large doses of phenethylamine (usually from a preworkout supplement) while on effective MAO-B inhibitor, and experience an intense short lived psychostimulant high, often an overdose from the first use. This high is always consistent, potent and akin to amphetamine while MAO-B is sufficiently inhibited.

I'm not really sure where to begin citing this since it's not well known, but it is known enough that a warning could do some good instead of what is written in the article currently Psychecaleb (talk) 20:14, 26 November 2023 (UTC)