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medication / antidepressants / Nardil and Parnate

MAOI antidepressants: Nardil and Parnate



Mental health problems

  • When other antidepressants have proven ineffective or contraindicated

  • Anxiety disorders

  • Atypical depression (more intense symptoms and aggressiveness)



Physical health issues

  • Allergy or a negative reaction

  • Heart problems

  • High blood pressure

  • Epilepsy

  • Parkinson disease

  • Kidney or liver failure

  • Diet containing tyramine


Mental health problems

Space the intake of an SSRI or an SSRINa and an MAOI by at least 14 days



Marked side effects, should only be used as a last resort



Not indicated for children under 16 years of age

Pregnancy and breast feeding

Birth defects; abstain while breastfeeding

Overdose Risks

Taking too high amounts of Nardil or Parnate can cause death.


Drugs interactions

Foods prohibited to consume with Nardil and Parnate because of the tyramine contained in certain meats, fish, vegetables, fruits, products derived from soy, alcoholic beverages. Tyramine acts in the human body as

a vasoactive agent, allowing the modification of the caliber of the vessels (vasoconstriction and vasodilation).

  • Aged cheeses (cheddar, brick, mozzarella, parmesan, etc.)

  • Liver, offal

  • Beans

  • Overripe fruits and vegetables

  • Meat and yeast extracts

  • Alcohol, red wine, aperitif and digestive liqueurs, beers

  • Sausages (salami, pepperoni, mortadella, etc.)

  • The sauerkraut

  • Salted or smoked fish

  • Sodium glutamate, soy sauce (therefore, Chinese dishes)

  • Figs, grapes

  • Chocolate, liquorice

  • The lawyers

  • Sour cream, yogurts

  • Coffee, colas

  • Snails, caviar

  • Canned or bagged soups


Medicines and drugs prohibited to consume with Nardil and Parnate

  • Cocaine, opium and all other illicit and controlled drugs

  • Stimulants like amphetamines (Ritalin, Cylert, etc.)

  • Prescription and non-prescription medications for the flu, colds, sinusitis, as well as cough syrups and decongestants

  • Antihistamines


-> Replace them with:

  • The  over-the-counter hypnotics (or sleeping pills) (Nytol, Sleep-Eze, etc.)

  • Over-the-counter pain medications (222, Tylenol, etc.)

  • Barbiturates

  • Certain narcotic pain relievers (Demerol)

  • Certain antiparkinsonian drugs such as Levodopa

  • Tricyclic antidepressants, SSRIs, NaSSRIs, real risk of serotonin syndrome (see below)


Serotonin syndrome: it's a medical emergency!

Toxic reaction produced by an excess of serotonin when taking or increasing the dose of the antidepressant; during an overdose or during an interaction with other drugs or substances.

More common with MAOIs, SSRIs and Effexor.


The symptoms are numerous:



   Muscle restlessness, rigidity and/or twitching

   Behavioral problems


   High blood pressure, racing heartbeat


   Can go as far as delirium

   Attack of violence


   suicide, homicide




Side effects (intellectual and motor functioning)

They depend on the dosage and duration of treatment, the metabolism of the individual and the context in which he lives.


  • Headache

  • Dizziness

  • Dry mouth

  • Blurring of vision

  • Restlessness, irritability



  • Nausea

  • Constipation



Weight gain



Voltage drop



  • Drowsiness

  • Sleeping troubles



  • sweats

  • Weakness



Sexual problems



With certain foods that contain tyramine or certain medications such as decongestants: hypertensive crisis (nausea, vomiting, violent headaches, palpitations, rapid heartbeat, fatal cerebral hemorrhage)

Withdrawal symptoms

Psychotropic drugs act in the brain just as they do in the rest of the body; and as we have seen, each person reacts differently. It's the same with weaning; the person's metabolism, the type of drug, the dose as well as the duration of the intake and its half-life, explain that the withdrawal effects are varied. We have listed the potential and main withdrawal symptoms of each class of psychotropic drugs. This list is incomplete, as not all withdrawal effects are listed; moreover, knowledge is rapidly evolving in this field. A person may have no withdrawal symptoms or experience one, a few, or even many. The medication reduction journey is specific to each person, just as each process is unique. For example, a person can take the same medicine twice at the same dose and the effects will be different. Gradual reduction, like removing 10  % of dose per week/month, reduces the frequency or intensity of withdrawal symptoms and the incidence of rapid relapses. It is very important to undertake this process with the collaboration of your doctor. The pharmacist also plays a key role and can provide guidance to monitor withdrawal effects for each drug. Most people who will have withdrawal symptoms will tolerate them without problems for the short duration of these symptoms.


Common and frequent withdrawal symptoms for all classes: anxiety, nervousness, restlessness, sleep problems, greater need to rest, sleep, irritability, fatigue.


Withdrawal symptoms for MAOI antidepressants:

Main psychological withdrawal symptoms:

  • Anxiety

  • Irritability

  • Hustle

  • Insomnia

  • Nightmares or dreams of intense realism (vivid)


Very rarely:

  • Paranoid delirium

  • Hallucinations


Main physical withdrawal symptoms:

  • Drowsiness

  • Volubility (abundance and ease of speech)

  • Difficulties expressing themselves

  • Lethargy (numbness of being, difficulty paying attention)

  • Movement disorders

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