medicationPrescription only (US)Tranylcypromine (Parnate) is an FDA-approved monoamine oxidase inhibitor (MAOI) requiring dietary tyramine restriction and drug-interaction precautionsPrescription-only in the US; not available over the counter
TranylcypromineBenefits, Dosage & Interactions
Also known as: Parnate, MAOI
Tranylcypromine, often known by its brand name Parnate, is a medication classified as a non-selective, irreversible monoamine oxidase inhibitor (MAOI). It is typically taken in the morning. The reported plasma half-life is about 2 hours, which shapes dosing frequency. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
How much Tranylcypromine do people take?
Trials reviewed in the cited systematic review of bipolar depression used tranylcypromine doses generally in the range of 20–60 mg/day. Route reported: Oral tablet. Frequency reported: Divided oral dosing, typically administered in split doses across the day per the reviewed protocols. These are amounts documented in the cited studies and labels for Tranylcypromine — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
See the full reported protocol and its sourcesResearched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
Evidence: Strong — 1 human randomized trial and regulatory approval on file.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence
1 human randomized trial and regulatory approval on file.
Plasma half-life
~2 h
Typical timing
in the morning
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
- Reported amounts
- Trials reviewed in the cited systematic review of bipolar depression used tranylcypromine doses generally in the range of 20–60 mg/day[1]
- Route studied
- Oral tablet[1]
- Frequency
- Divided oral dosing, typically administered in split doses across the day per the reviewed protocols[1]
- Cycle length
- Treatment courses in the reviewed studies ran for several weeks to months[1]
- Half-life
- Not quantified in the cited sources[1]
Reported for Tranylcypromine in the cited sources. Published ranges are not dosing advice.
References & evidence
Documents the Tranylcypromine entry is written from. Each number matches an inline marker above.
- [1]Efficacy of Tranylcypromine in Bipolar Depression: A Systematic ReviewHeijnen WT, De Fruyt J, Wierdsma AI, Sienaert P · Journal of Clinical Psychopharmacology · 2015 · Peer-reviewed · PMID 26479223
- [2]Sequenced Treatment Alternatives to Relieve Depression (STAR*D): rationale and designRush AJ, Fava M, Wisniewski SR, Lavori PW · Controlled Clinical Trials · 2004 · Peer-reviewed · PMID 15061154
References & Evidence
Sources on this page that document Tranylcypromine dosing, timing and safety.
- [1]U.S. National Library of Medicine View source
- [2]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is Tranylcypromine?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine, often known by its brand name Parnate, is a medication classified as a non-selective, irreversible monoamine oxidase inhibitor (MAOI). It is primarily used to treat major depressive disorder, particularly in individuals who have not responded adequately to other antidepressant therapies (NIH MedlinePlus). As an MAOI, it works by inhibiting the activity of monoamine oxidase enzymes in the body, which are responsible for breaking down neurotransmitters such as serotonin, norepinephrine, and dopamine. The resulting increase in the levels of these neurotransmitters in the brain is thought to contribute to its antidepressant effects. Tranylcypromine has a relatively short half-life of approximately 2.5 hours, but its pharmacological effects persist much longer due to its irreversible inhibition of MAO enzymes (DrugBank).
What does the research say about Tranylcypromine?
Tap a section to expand.
Tranylcypromine exerts its therapeutic effects by inhibiting both monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B) enzymes in the body. MAO-A preferentially metabolizes serotonin, norepinephrine, and dopamine, while MAO-B preferentially metabolizes dopamine and phenylethylamine (PubChem, DrugBank). By irreversibly binding to and inhibiting these enzymes, tranylcypromine prevents the breakdown of these neurotransmitters in the presynaptic neuron. This leads to an accumulation of serotonin, norepinephrine, and dopamine in the synaptic cleft, thereby increasing their availability to postsynaptic receptors. The chronic increase in neurotransmitter availability is believed to lead to adaptive changes in receptor sensitivity and intracellular signaling pathways, which are ultimately responsible for the antidepressant action. Unlike some other MAOIs, tranylcypromine is structurally similar to amphetamine and may possess some mild stimulating properties independent of its MAOI activity (DrugBank).
Source for this section: Sources for How does Tranylcypromine work?: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine's primary recognized benefit is the treatment of atypical depression or major depressive disorder, particularly in cases resistant to other antidepressant treatments (Mayo Clinic, NIH MedlinePlus). Clinical studies have consistently shown its efficacy in reducing depressive symptoms, including low mood, anhedonia, and fatigue, in populations where other treatment modalities have failed. It may be considered for patients who have not achieved satisfactory improvement with tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), or other classes of antidepressants (FDA label). Beyond its approved indication, tranylcypromine has also been explored, though less commonly and often off-label, for conditions such as anxiety disorders or panic disorder when co-occurring with depression where other treatments have been ineffective (Cochrane Library reviews on MAOIs). Its stimulating effects can sometimes be beneficial in depressed patients experiencing significant psychomotor retardation. However, due to its significant drug and food interactions, its use is generally reserved for refractory cases (NIH MedlinePlus).
The efficacy of tranylcypromine in treating atypical and treatment-resistant depression is supported by various clinical studies and long-standing clinical experience. Early trials and subsequent meta-analyses have consistently demonstrated its effectiveness in patients who have failed to respond to other antidepressant classes (Cochrane reviews). For instance, numerous studies have shown superior efficacy of MAOIs, including tranylcypromine, over placebo and sometimes even over tricyclic antidepressants in specific subtypes of depression, such as atypical depression, characterized by mood reactivity, hyperphagia, hypersomnia, and leaden paralysis (Examine.com). Although not as frequently studied as newer antidepressants due to its place as a second- or third-line treatment, its role in refractory depression is well-established in clinical guidelines (Mayo Clinic). The evidence base, while older for some of the foundational studies, remains robust for its approved indications and specific patient populations.
Common side effects associated with tranylcypromine include orthostatic hypotension (a drop in blood pressure upon standing), dizziness, dry mouth, blurred vision, headache, insomnia, constipation, and sexual dysfunction (FDA label). Some individuals may experience anxiety, agitation, or restlessness. Less common but more serious side effects can include hypertensive crisis, particularly if dietary restrictions are not followed, or if certain medications are co-administered. Serotonin syndrome is another serious but rare adverse effect that can occur with concomitant use of other serotonergic drugs. Hepatic toxicity and blood dyscrasias are extremely rare but have been reported. Regular monitoring by a healthcare professional is important to manage and mitigate potential side effects. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What are the side effects of Tranylcypromine?: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine carries several significant warnings due to its mechanism of action. The most critical warning concerns the risk of hypertensive crisis, which can be life-threatening. This is primarily triggered by consuming foods and beverages high in tyramine (e.g., aged cheeses, cured meats, certain fermented products, tap beer) or by co-administering certain medications that impact catecholamine levels. Patients must adhere strictly to a tyramine-restricted diet. There is also a risk of serotonin syndrome, a potentially fatal condition, if tranylcypromine is used concurrently with other serotonergic agents (e.g., SSRIs, SNRIs). The medication should not be abruptly discontinued, as withdrawal symptoms like agitation, confusion, and hallucinations may occur; it should be tapered under medical supervision. Due to its potential to induce mania, tranylcypromine should be used with caution in patients with bipolar disorder. Patients should be monitored for suicidal ideation, especially at the initiation of treatment or during dose adjustments. The use of tranylcypromine in elderly patients requires particular caution due to increased sensitivity to side effects. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for Who should avoid Tranylcypromine?: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine is contraindicated in individuals with a history of hypersensitivity to the drug or any of its components. It is absolutely contraindicated in patients with pheochromocytoma due to the risk of severe hypertensive crisis (FDA label). Other contraindications include severe liver or kidney impairment, progressive cerebrovascular disease, or a history of recurrent severe headaches. Conditions such as uncompensated congestive heart failure, severe hypertension, or a history of cardiovascular disease may also contraindicate its use. The concomitant use of other MAO inhibitors, serotonergic antidepressants (SSRIs, SNRIs), certain opioids (e.g., meperidine), and other sympathomimetic agents is contraindicated due to the risk of drug interactions leading to severe adverse effects like serotonin syndrome or hypertensive crisis. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for When should Tranylcypromine not be taken?: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine must not be mixed with a wide range of medications and certain foods/beverages due to severe and potentially life-threatening interactions. Key medications to avoid include: all other monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), bupropion, carbamazepine, triptans (for migraine), certain opioids (e.g., meperidine, tramadol, methadone, fentanyl), cyclobenzaprine, St. John's Wort, dextromethorphan, and any sympathomimetic agents (e.g., pseudoephedrine, phenylephrine, amphetamines, methylphenidate, cocaine). Concomitant use with these agents can lead to serotonin syndrome, hypertensive crisis, or other severe adverse reactions. Additionally, certain foods and beverages must be avoided due to their high tyramine content, which can precipitate a hypertensive crisis. These include aged cheeses, fermented sausages (salami, pepperoni), cured or smoked meats, fava beans, some broad beans, sauerkraut, yeast extracts, tap beer, red wine, and some soy products (e.g., tofu, soy sauce). Any over-the-counter cold or allergy medications containing decongestants should also be avoided. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Source for this section: Sources for What should you not mix with Tranylcypromine?: Jumps to this entry in the sources and references list at the end of the page.
Tranylcypromine is typically taken in the morning or divided into morning and early afternoon doses. This dosing schedule is often chosen to minimize the potential for insomnia, which can be a side effect given its stimulating properties (FDA label). It can be taken with or without food, but consistency in relation to meals may help some individuals manage gastrointestinal side effects. Due to its irreversible MAO inhibition, the effects of the medication persist longer than its half-life, so consistent daily administration is important. Individual needs for timing can vary, and a licensed clinician will provide guidance based on the specific response and tolerability.
Source for this section: Sources for When should you take Tranylcypromine?: Jumps to this entry in the sources and references list at the end of the page.
Put it into practice
Reading about Tranylcypromine is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.
What interacts with Tranylcypromine?
| Interacts with | Severity | Type | What happens | What to do |
|---|---|---|---|---|
| Any supplement + medication | Note | Category ruleConfidence: theoretical | Some supplements change how the body processes medications (absorption, liver enzymes, or additive effects).Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Specific pairs are checked against a licensed drug database and shown with their own severity. Always confirm with your provider or pharmacist. |
| Any vitamin + medication | Note | Category ruleConfidence: theoretical | Certain vitamins interact with specific medications (e.g., vitamin K with blood thinners).Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Specific pairs are checked against a licensed source; confirm with your provider. |
| Sertraline | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Any + | Avoid | Category ruleConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Escitalopram | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Fluoxetine | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Citalopram | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Paroxetine | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Duloxetine | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Venlafaxine | Avoid | Compound pairConfidence: theoretical | Combining SSRIs/SNRIs with MAOIs can cause life-threatening serotonin syndrome.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. Allow at least 14 days between stopping one and starting the other (5 weeks for fluoxetine). |
| Amphetamine Salts | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Lisdexamfetamine | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Methylphenidate | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Dexmethylphenidate | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Synephrine | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Yohimbine HCl | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
| Hordenine | Avoid | Compound pairConfidence: theoretical | MAOI blocks catecholamine breakdown; combining with sympathomimetics can trigger hypertensive crisis.Source for this interaction: Jumps to this entry in the sources and references list at the end of the page. | Do not combine. |
Frequently asked questions about Tranylcypromine
While primarily indicated for depression, Tranylcypromine may be used off-label for anxiety disorders or panic disorder when co-occurring with depression and other treatments have failed. This decision must be made by a licensed clinician after careful consideration of risks and benefits.
Like many antidepressants, it can take several weeks for the full therapeutic effects of Tranylcypromine to become apparent. Initial improvements might be noticed sooner, but consistent use as prescribed is necessary to achieve optimal benefits.
Patients must strictly avoid foods and beverages high in tyramine, including aged cheeses, fermented meats (like salami), fava beans, tap beer, red wine, sauerkraut, and yeast extracts. Failure to do so can lead to a dangerous hypertensive crisis. A comprehensive list will be provided by your clinician and pharmacist.
Tranylcypromine is not considered addictive in the conventional sense, as it does not typically produce drug-seeking behavior or euphoria. However, abrupt discontinuation can lead to withdrawal symptoms, so it should always be tapered under medical supervision.
Tranylcypromine is a medication, and interactions are possible with prescriptions, hormones, peptides and other supplements in the same routine. Because Tranylcypromine is usually taken in the morning, most avoidable conflicts come from what else lands in that same window. With a reported plasma half-life near 2 hours, separating doses can change the picture as much as removing one. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Tranylcypromine with no sign-up.
Tranylcypromine is typically taken in the morning. The reported plasma half-life is about 2 hours, which is what drives how often it is redosed. Ranges reported in the literature are not recommendations; use the dose your clinician or the product label gives you.
Combining a medication like Tranylcypromine with TRT is usually a question of labs rather than a blanket yes or no: the ester, injection interval and any aromatase inhibitor all change the answer. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
Each peptide class carries its own profile against Tranylcypromine: a healing peptide raises different questions than a GLP-1 agonist or a growth-hormone secretagogue. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
A short plasma half-life of roughly 2 hours is why protocols often split Tranylcypromine across the day rather than using a single dose. It is typically taken in the morning. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
Because Tranylcypromine clears quickly (plasma half-life around 2 hours), a missed dose leaves a real gap in exposure rather than being buffered by what is still in your system. Doubling up to "catch up" is generally not appropriate unless the label or prescriber says so. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
For Tranylcypromine the useful record is the dose, the time it was actually taken, and what else was taken in the same window. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
Trials reviewed in the cited systematic review of bipolar depression used tranylcypromine doses generally in the range of 20–60 mg/day. Route reported: Oral tablet. Frequency reported: Divided oral dosing, typically administered in split doses across the day per the reviewed protocols. These are amounts documented in the cited studies and labels for Tranylcypromine — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
Which studies looked at Tranylcypromine?
Peer-reviewed research indexed in PubMed. Each entry links to the original record.
- 1.The prescriber's guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression(opens PubMed in a new tab)CNS Spectr · 2023 · PMID 35837681 · https://pubmed.ncbi.nlm.nih.gov/35837681/
- 2.60 Years of Combining Tranylcypromine: A Systematic Review of Available Evidence(opens PubMed in a new tab)J Clin Psychopharmacol · 2022 · PMID 34928561 · https://pubmed.ncbi.nlm.nih.gov/34928561/
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- MedlinePlus(opens in a new tab)U.S. National Library of Medicine · medlineplus.gov/druginfo/meds/a682088.html
- PubChem CID 2723716(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/2723716
Verify at
Publisher search links for Tranylcypromine. These are places to check the information — they are not citations, so they are not numbered.
- Cochrane Library(publisher search, opens in a new tab)Cochrane · publisher search
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- Examine.com(publisher search, opens in a new tab)Examine.com · publisher search
- FDA-approved labeling (DailyMed)(publisher search, opens in a new tab)U.S. Food and Drug Administration · publisher search
- Mayo Clinic(publisher search, opens in a new tab)Mayo Clinic · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on Tranylcypromine?
Plain-text summary, safe to quote verbatim:
Tranylcypromine, often known by its brand name Parnate, is a medication classified as a non-selective, irreversible monoamine oxidase inhibitor (MAOI). It is typically taken in the morning. The reported plasma half-life is about 2 hours, which shapes dosing frequency. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
Source: DoseRoutine — https://doseroutine.com/library/tranylcypromine
Tranylcypromine cheat sheet
DoseRoutine cheat sheet · Medication
Tranylcypromine
Tranylcypromine, often known by its brand name Parnate, is a medication classified as a non-selective, irreversible monoamine oxidase inhibitor (MAOI).
Evidence
Strong
1 human randomized trial and regulatory approval on file.
Studied range
Trials reviewed in the cited systematic review of bipolar depression used tranylcypromine doses generally in the range of 20–60 mg/day
Route
Oral tablet
Frequency studied
Divided oral dosing, typically administered in split doses across the day per the reviewed protocols
Half-life
~2 h
Timing
in the morning
Prescription only (US)Tranylcypromine (Parnate) is an FDA-approved monoamine oxidase inhibitor (MAOI) requiring dietary tyramine restriction and drug-interaction precautionsPrescription-only in the US; not available over the counter
Studied ranges, not dosing advice. Not medical advice — talk to a clinician. doseroutine.com/library/tranylcypromine
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). Tranylcypromine — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/tranylcypromine
What compounds are similar to Tranylcypromine?
Others in the medication category or studied for the same goals.