Parnate (Tranylcypromine) for Depression

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Parnate (tranylcypromine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with major depressive disorder (MDD) who have not responded to other antidepressant treatments.

What Members Say

MHT logo These insights are based on 53 comments about Parnate from MyDepressionTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Depression symptoms can improve after other antidepressants have not helped.
Long-term mood stability is possible for some people, including reports lasting many years.
Some people notice a lift in mood early in treatment.

Considerations:

Dizziness, faintness, and falls can happen, especially with low blood pressure.
Diet changes and avoiding high-tyramine foods and drinks require ongoing attention.
Suicidal thoughts can worsen, especially early in treatment or after dose changes.

How Parnate Works and How It’s Taken

Parnate is a type of medication called a monoamine oxidase inhibitor (MAOI). It works by blocking an enzyme called monoamine oxidase, which normally breaks down certain brain chemicals. By blocking this enzyme, Parnate may increase the levels of brain chemicals linked to mood.

The exact way Parnate works to treat depression is not fully known. Doctors prescribe Parnate for adults with major depressive disorder who have not improved enough with other antidepressants. By targeting this pathway, the medication may help manage symptoms.

Parnate is given as a tablet by mouth. It is usually taken in divided doses each day. Your doctor may change your dose over time based on how well it is working.

Typical Dosing for Depression

The recommended starting dose of Parnate for depression is 30 milligrams per day, taken in divided doses.

If needed, the dose may be increased by 10 milligrams per day every one to three weeks. The maximum dose is 60 milligrams per day, typically taken as 30 milligrams twice daily.

Doctors may increase the dose more slowly in people at risk for low blood pressure. When stopping treatment, the dose should be lowered gradually rather than stopped suddenly.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Parnate

These insights are based on member experiences with Parnate and are not meant to be medical advice.

Members say Parnate may help when other antidepressants have not worked, but they also stress the importance of monitoring side effects, following dietary restrictions, and staying in close contact with a doctor.

1

Watch for dizziness and low blood pressure.
Members note that dizziness, faintness, and falls can happen, especially when standing up too quickly.
2

Take dietary restrictions seriously.
Avoiding high-tyramine foods and drinks is an important part of treatment and requires ongoing attention.
3

Stay alert for mood changes early in treatment.
Members and prescribing information note that suicidal thoughts can worsen, especially early in treatment or after dose changes.

Parnate Side Effects

In clinical studies of Parnate for major depressive disorder in adults who have not responded adequately to other antidepressants, some of the most common side effects occurred in more than 30 percent of people. These include:

Dry mouth
Dizziness
Insomnia (trouble sleeping)
Sedation (sleepiness)
Headache
Feeling overly stimulated or overexcited
Constipation
Blurred vision
Tremor (shakiness)

Serious Side Effects and Warnings

Parnate can cause serious side effects that require immediate medical attention. These include:

Suicidal thoughts and behaviors — The risk may be higher in people age 24 and younger, especially early in treatment or when the dose changes.
Hypertensive crisis — A sudden, severe rise in blood pressure can happen after eating or drinking high-tyramine foods or beverages.
Serotonin syndrome — This is a potentially life-threatening reaction that can happen when Parnate is combined with certain other medicines.
Mania or hypomania — This can include unusually high mood, increased energy, or risky behavior, especially in people with bipolar disorder.
Low blood pressure, including postural hypotension and fainting — Blood pressure can drop when standing up.
Liver problems — Hepatitis or elevated liver enzymes may cause symptoms such as fatigue, nausea, or yellowing of the skin or eyes.
Seizures — Convulsions can occur.
Hypoglycemia (low blood sugar) — This can occur in people with diabetes.
Withdrawal symptoms after stopping or lowering the dose too quickly — Symptoms can include dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, sweating, or abnormal dreams.

Get medical help right away if you think you are having a serious reaction.

How To Save on Parnate

Advanz Pharma, the manufacturer of Parnate, offers the NAVIGATE patient support program. The program provides confidential support services and, for eligible individuals, financial assistance. At this time, it does not appear to list a Parnate-specific copay or savings offer.

The NAVIGATE program also offers personalized support, including access to a dedicated Nurse Case Manager for each patient. To learn more, visit the Advanz Pharma patients and caregivers page.

What To Know Before Taking Parnate

Before starting Parnate, your doctor will check if you have a history of mania and will measure your blood pressure.

Before taking Parnate, tell your healthcare provider about all your medical conditions, including if you:

Have high or low blood pressure
Have heart problems
Have had a stroke or other brain blood vessel problems
Have headaches
Have, or have a family history of, bipolar disorder, mania, or hypomania
Have plans for a surgery
Have liver or thyroid problems
Have had seizures or convulsions
Have diabetes

Tell your doctor if you have any allergies to tranylcypromine or any ingredients in Parnate.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Always check with your doctor before taking any new medicine or supplements.

Taking Parnate with certain medicines may cause serious side effects, including a sudden, dangerous increase in blood pressure (hypertensive crisis) or a condition called serotonin syndrome.

Parnate and some other medicines may affect each other, causing serious side effects. Parnate may affect the way other medicines work, and other medicines may affect how Parnate works.

Do not take Parnate with certain other medicines. These include:

Other antidepressants, such as MAOIs, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants
Stimulant medicines, such as amphetamines
Medicines found in some cold, allergy, or weight-loss products that can raise blood pressure
Migraine medicines called triptans
Certain other medicines, including buspirone, carbamazepine, cyclobenzaprine, dextromethorphan (found in some cough medicines), dopamine, levodopa, meperidine, methyldopa, rasagiline, reserpine, SAM-e (a supplement), tapentadol, tetrabenazine, and tryptophan

Always check with your doctor before taking any new medicine or supplements.

Do not take Parnate if you have a tumor called pheochromocytoma or a similar tumor called a paraganglioma.

Do not eat foods or drink beverages that are high in tyramine while taking Parnate and for two weeks after stopping it. Eat fresh foods, and avoid foods if you are not sure how they were stored.

Do not drive or use heavy machinery until you know how Parnate affects you. Do not drink alcohol while taking Parnate.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Parnate, talk with your doctor about the risks and benefits. Do not breastfeed while taking Parnate.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Parnate?
Parnate is used to treat adults with major depressive disorder who have not gotten better with other antidepressants.

The prescribing information does not include a specific efficacy percentage, but it states that Parnate is indicated for this group and is not intended as the first treatment for major depressive disorder because of its serious potential risks, drug interactions, and dietary restrictions.

Your doctor will monitor how well Parnate is working and may adjust your dose if needed.

What are the most important risks of taking Parnate?
Parnate can cause serious side effects. It may increase suicidal thoughts or actions, especially in people age 24 and younger, and during the first few months of treatment or when the dose is changed.

Parnate can also cause a sudden and dangerous rise in blood pressure (hypertensive crisis). This can happen if you eat foods high in tyramine or take certain medicines.

Another serious risk is serotonin syndrome, which can happen if Parnate is taken with some other medicines. Symptoms of these serious reactions may include sudden severe headache, changes in blood pressure, fast or slow heartbeat, sweating, fever, confusion, or muscle stiffness. Get medical help right away if you have any unusual or severe symptoms.

What should I avoid while taking Parnate?
You must avoid foods and drinks that are high in tyramine while taking Parnate and for two weeks after stopping it. These include certain aged, fermented, or spoiled foods, such as aged cheeses, cured meats like salami, soy sauce, sauerkraut, and tap beer.

You should also avoid many medicines, including some antidepressants, cold and allergy medicines, and supplements, because they can cause serious reactions. Do not take any new medicine without talking to your doctor first.