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Description
Drug Description:
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The manufacturer of Parnate is Glaxo Smith Kline.
Indication:
Parnate is an antidepressant medication used to treat symptoms of major depressive disorder (MDD) in adult patients who have not responded adequately to other antidepressants. Parnate is not indicated for use in children or adolescents less than 18 years of age.
MDD, also referred to as depression or clinical depression, is a common mood disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities for long periods of time. Symptoms of MDD are often severe enough to affect work, school, and social functioning as well as relationships with others, and this disorder may require long-term treatment.
Parnate, which belongs to a class of medications known as monoamine oxidase inhibitors (MAOIs), helps restore the balance of certain natural substances (neurotransmitters) in the brain to improve mood and feelings of well-being. This medication should not be used as the first medicine to treat your MDD.
Dosage and Administration:
The dose of Parnate prescribed will vary depending on the individual being treated. Follow all your healthcare provider’s instructions to ensure the best results during treatment.
The recommended daily dosage of Parnate is 30 mg in divided doses. If there is no adequate response, the dosage can be increased in increments of 10 mg per day every 1 to 3 weeks to a maximum dosage of 30 mg twice daily (60 mg per day). A more gradual dosage increase should be considered in patients at risk for low blood pressure (hypotension).
- Swallow Parnate tablets whole and do not crush or chew them
- Take your Parnate dose(s) at the same time every day and do not suddenly stop taking this medication
- Continue taking this medication as your healthcare provider prescribed, even if you feel much better
Your dosage of Parnate should not exceed 60 mg per day
Side Effects:
Parnate may cause some side effects to develop while affecting the chemicals in your brain. Speak with your healthcare provider for more information regarding any symptoms you encounter while taking Parnate.
The most common side effects associated with Parnate include:
- Dry mouth
- Dizziness
- Problems sleeping
- Sleepiness
- Headache
- Overexcitement
- Constipation
- Blurred vision
- Shakiness (tremor)
Serious Side Effects
Some more serious adverse reactions may occur when taking Parnae. Stop using Parnate and contact your healthcare provider if you develop any of the following side effects:
- An increase in suicidal thoughts or actions
- Pay close attention to any changes in mood, behaviors, thoughts, or feelings, especially when you first start taking Parnate or when your dose is changed
- A sudden severe increase in blood pressure (symptoms include sudden or severe headache, neck stiffness or soreness, nausea or vomiting, dilated pupils, shortness of breath, excessive sweating, fast or slow heartbeat with chest pain)
- Serotonin syndrome, a potentially life-threatening problem that can occur when taking Parnate with certain other medications (symptoms include agitation, confusion, changes in blood pressure, high body temperature, dizziness, flushing, fever, tremors/stiff muscles)
- If you experience any of these symptoms, call your healthcare provider or go to the nearest emergency room immediately
- Mania or hypomania (manic episodes) in people with a history of bipolar disorder (symptoms include greatly increased energy, racing thoughts, talking more/faster than usual, reckless behavior, excessive happiness or irritability
- Withdrawal symptoms (dizziness, nausea, headache, irritability/agitation, problems sleeping, anxiety, sweating, confusion, mood changes, ringing in ears)
- Kidney problems
- Seizures
- Low blood pressure
- Low blood sugar (hypoglycemia)
Allergic Reactions
Do not use Parnate if you are allergic to tranylcypromine or any of the other listed tablet ingredients. If you develop signs of an allergic reaction, stop taking this antidepressant and call your healthcare provider.
Warnings and Precautions:
Be aware of an increased risk of suicidal thoughts and behavior while taking an antidepressant (especially pediatric and young adult patients) and speak with your healthcare provider if you experience any suicidal thoughts or behaviors.
A hypertensive crisis can occur when you eat certain foods and drink certain beverages containing a substance called tyramine while taking Parnate or after discontinuing it (see table below).
| Category | Foods and Beverages Containing Tyramine |
| Meat, Poultry, and Fish | Air-dried, aged and fermented meats, sausages, salamis, pepperoni
Liver Pickled herring Any spoiled or improperly stored meat, poultry, fish |
| Vegetables | Fava or broad bean pods |
| Dairy (milk products) | Cheeses (aged cheeses including parmesan, aged cheddar, bleu cheese) |
| Alcoholic beverages | Beer, wine |
| Other foods | Concentrated yeast extract
Most soybean products (including soy sauce and tofu) Sauerkraut Foods containing excessive amounts of caffeine/chocolate |
Do not drive, operate heavy machinery, or do other dangerous activities until you know how Parnate affects you. Do not drink alcohol while taking Parnate.
Some drugs have the potential to interact with Parnate and cause adverse reactions. Tell your healthcare provider about all medications you take, including over-the counter medications, and especially the following:
- Other MAOIs (phenelzine sulphate, isocarboxazid, nialamide, and others)
- Other antidepressants (SSRIs, SNRIs, tricyclic antidepressants, and others such as amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine)
- Triptans
- Sympathomimetics (pseudoephedrine, phenylephrine, and )
- Antihistamines
- Triptans
- Buspirone
- Carbamazepine
- Cyclobenzaprine
- Dextromethorphan
- Dopamine
- Levodopa and methyldopa
- Meperidine
- Rasagline
- Resperine
- Tapentadol
- Tetrabenazin
It is important to tell your healthcare provider if you:
- Have high or low blood pressure
- Have heart problems
- Have cerebrovascular problems or have had a stroke
- Have headaches
- Have or have a family history of bipolar disorder, mania, or hypomania
- Plan to have surgery
- Have liver or thyroid problems
- Have or have had seizures or convulsions
- Have diabetes
- Are pregnant or plan to become pregnant
- Are breastfeeding or plan to breastfeed
have liver or thyroid problems have or have had seizures or convulsions have diabetes are pregnant or plan to become pregnant. Tranylcypromine sulfate tablets may harm your unborn baby. are breastfeeding or plan to breastfeed
Form and Strength:
This antidepressant medication is available as a 10 mg tablet.
FAQs:
Why is it necessary to avoid foods and beverages containing tyramine?
Tyramine is a substance that can trigger nerve cells to release norepinephrine, a hormone that increases blood pressure and heart rate. Avoiding consumption of foods/beverages that contain high amounts of tyramine while taking Parnate can help prevent a hypertensive crisis.
What is serotonin syndrome?
Serotonin is a chemical (known as a neurotransmitter) produced naturally in the body that carries messages between nerve cells and plays a key role in certain body functions. Serotonin syndrome is caused by medications that build up high levels of serotonin in the body. It occurs most often when medications containing serotonin are combined, such as an antidepressant and a migraine medication. Left untreated, this syndrome can cause death. Therefore, recognizing signs and symptoms of serotonin syndrome (mild: shivering and diarrhea to severe: muscle rigidity, fever, and seizures) is critical while taking Parnate and requires immediate medical attention
Resources:
- https://pdf.hres.ca/dpd_pm/00053977.PDF
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012342s064lbl.pdf
- https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Tranylcypromine-(Parnate)
- https://www.webmd.com/diet/foods-high-in-tyramine
- https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
