Because of its wide range of application, phenelzine has been evaluated through countless case studies for nearly seventy years within the scientific research community. Whether the drug is being used to improve social phobias, alleviate depression, or treat various addictions, it has undoubtedly proven it’s a useful clinical application.
Read on to learn the many benefits phenelzine may bring to one’s life and the drawbacks that it possesses.
Note: By writing this post, we are not recommending this drug. Some of our readers who were already taking the drug requested that we commission a post on it, and we are simply providing information that is available in the scientific literature. Please discuss your medications with your doctor.
What Is Phenelzine?
Phenelzine sulfate, also known as Nardil, is a monoamine oxidase inhibitor. Monoamine oxidase inhibitors (MAOIs) are effective antidepressants [R].
Phenelzine was first recognized in the 1950s when its clinical application became evident, and it has since gained a great deal of attention as an all-encompassing treatment for multiple mental ailments. From anxiety to PTSD, phenelzine has been a prominent player in the psychological pharmaceutical industry for some time now.
Mechanisms of Phenelzine
1) Phenelzine Inhibits MAO
Phenelzine decreases both monoamine oxidase (MAO) and semicarbazide-sensitive amine oxidase activities. Fat tissue contains high amounts of these enzymes. In turn, phenelzine directly decreases fat cell storage and production [R].
2) Other Mechanisms
Phenelzine decreases tyrosine aminotransferase, an enzyme thought to play a role in tyrosinemia type II (Richner-Hanhart syndrome), hepatitis (a virus that attacks the liver), and hepatic carcinoma (liver cancer) recovery in rat livers [R, R].
Uses of Phenelzine
1) Phenelzine Treats Major Depression and Anxiety
In a study (DB-RCT) of patients with major depression, 45 and 60 mg daily doses of phenelzine were significantly more effective at preventing depression relapse than the placebo [R].
Additionally, in cases of psychotic, probably psychotic, and nonpsychotic depression, all forms were improved with phenelzine [R].
In a study (DB-RCT) of 117 neurotic patients, phenelzine reduced anxiety and depression symptoms [R].
2) Phenelzine Improves Phobias
In an 11-person study, phenelzine improved social phobias and reduced interpersonal hypersensitivity [R].
Phenelzine reduced subjective anxiety during exposure to predetermined phobias in a study (DB-RCT) of 40 social phobia patients [R].
In a 6-person study, phenelzine was effective in treating social phobias that had been unresponsive to other treatments [R].
3) Phenelzine Helps Treat Borderline Personality Disorder
In a study (DB-RCT) of 54 borderline personality patients, phenelzine decreased depression and irritability while increasing excitement and reactivity [R].
Phenelzine was tested against imipiramine and a placebo. It demonstrated the highest percentage of improvement in the symptoms of 60 patients (DB-RCT) who have atypical depression and borderline personality disorder [R].
4) Phenelzine Treats PTSD
Five patients treated with phenelzine felt calmer and stopped having nightmares/flashbacks of traumatic war material. Their behavior was also significantly less violent and startle reactions were lessened [R].
In a study (DB-RCT) of 34 male veterans, phenelzine supplementation (15 to 75 mg daily) significantly reduced PTSD symptoms. The subjects reported less anxiety, nightmares, flashbacks, and intrusive thoughts. However, their emotional numbing, emotional distance, and suppression of memories did not improve [R].
5) Phenelzine Treats Mutism
Phenelzine successfully cured selective mutism (anxiety disorder where people who can normally speak cannot speak in certain situations) in a case study [R].
It also cured selective mutism in four children, ages 5 ½ to 7. There was no recurrence of mutism after discontinuing phenelzine use [R].
6) Phenelzine May Help with Cocaine Addiction
Phenelzine corrected neurotransmitter defects caused by chronic cocaine usage in 26 addiction patients. This reduced their craving for cocaine and successfully treated their cocaine addiction [R].
7) Phenelzine Treats Bulimia
In a study (DB-RCT) of 50 bulimic patients, phenelzine decreased binge eating frequency. However, its side effects caused some patients to discontinue phenelzine use [R].
It also decreased bulimic and depressive symptoms in another 24 person study (DB-RCT) [R].
8) Phenelzine May Decrease Nicotine Dependence
In a study of rats, phenelzine decreased dependence of high doses of nicotine [R].
9) Phenelzine May Increase Pain Resistance
In mice, injections (either by itself or in combination with amitriptyline) increased tolerance to pain. The mice injected with phenelzine were more tolerant to pain than mice injected with salt water for up to 24 hours [R].
10) Phenelzine May Treat OCD
In a study (DB-RCT) of 30 OCD patients, phenelzine decreased obsessive-compulsive and depressive symptoms [R].
11) Phenelzine May Relieve Chronic Diarrhea
Phenelzine cured a patient of chronic (36-year lasting) diarrhea and underlying depression [R].
Side Effects of Nardil
Phenelzine can be addictive [R].
Phenelzine has been reported to cause death, but only when taken at abnormally high doses (10-50 times greater than a clinical dosage) [R].
Phenelzine has, in rare cases, caused liver failure [R].
Common Side Effects of Phenelzine
- Weight gain
- Low blood pressure
- Hypertension (high blood pressure)
- Tachycardia (abnormally rapid heart rate)
- Sexual dysfunction
- Urinary hesitancy (involuntary hesitation during urination)
- Myoclonic jerks (brief involuntary muscle twitching)
- Dry mouth
Phenelzine Reduces Blood Levels of Vitamin B6
In a study of 19 patients who took phenelzine, their vitamin B6 blood levels were reduced by an average of 54% compared to the control group [R].
Phenelzine May Cause Heart Failure
A 23-year-old woman had massive phenelzine overdose (2,760 mg) and developed severe and unexplained hypotension, impaired left ventricular function, and acute myocarditis. She died 3 days after [R].
Phenelzine May Cause Low Blood Sugar
Phenelzine Can Damage Mental Health
A reported case of delusional parasitosis (the mistaken belief that one is being infested by parasites) has been associated with taking phenelzine [R].
Phenelzine is also associated with increased hostility [R].
Limitations and Caveats
Many of Phenelzine’s benefits have yet to be investigated outside of animal studies.
Though these studies point in the direction of benefit, it is still advised to be cautious when using and supplementing the drug. All MAOIs should be obtained through prescription, and only after consulting a physician on your possible need for the medication.
Phenelzine should not be taken in conjunction with general anesthetics, as it prolongs the effects of these medications, such as suxamethonium [R].
Rapid switch from phenelzine to tranylcypromine may induce stroke [R].
Beers on tap may contain high tyramine levels and should not be consumed while taking phenelzine as it could result in hypertensive episodes [R].
Surprisingly, phenelzine may cause hypertensive crises when taken with cheese. Cheese has been found to also be high in tyramine [R].
Dosages for phenelzine/Nardil often vary depending on its use:
In patients recovering from acute depression, 45 – 60 mg/day is recommended [R].
For the treatment of social anxiety disorder, a dose of 66 mg/day is effective [R].
In patients with depression, anxiety, and severe phobias, both 45 and 90 mg daily doses of phenelzine improved their symptoms. However, 90 mg was more effective [R].
For curing selective mutism in children, 30 – 60 mg/day of phenelzine is effective [R].
For treating PTSD, 60 mg/day is an effective treatment dosage [R].
Users commented that Nardil improved their anxiety, depression, and PTSD. It also helped with their social phobias. Phenelzine was effective in treating their symptoms when many other drugs did not work.
However, one user noted that Nardil caused him to gain over 50 pounds, and have sexual dysfunction after 4 years of use.