Tranylcypromine
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Tranylcypromine is an irreversible nonselective MAOI used for major depressive disorder when other antidepressants have not worked adequately. It requires strict management of tyramine intake, contraindicated medications, and washout periods because hypertensive crisis and serotonin syndrome can be life-threatening. It is not generally used as first-line antidepressant therapy because of these safety requirements.
Exploratory record, not a reviewed medical publication.
See the editorial and medical-review policies for the publication gate.
This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Tranylcypromine is an irreversible nonselective MAOI used for major depressive disorder when other antidepressants have not worked adequately. NutriStack rates the supporting evidence as strong. Common adult dosing is Recommended daily dosage is 30 mg in divided doses; increase by 10 mg/day every 1 to 3 weeks if needed, up to 60 mg/day., though a prescriber sets the actual dose. This profile indexes 3 sources.
The bottom line
Evidence rating strong. Most-documented uses: treatment-resistant major depressive disorder, atypical depressive symptoms in selected patients, depression not responding to ssris, snris, tcas, or other strategies. 3 sources indexed (2005–2025), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Tranylcypromine irreversibly inhibits MAO-A and MAO-B, reducing metabolism of serotonin, norepinephrine, dopamine, and tyramine. Increased central monoamine availability supports antidepressant effects, while impaired tyramine breakdown can trigger abrupt catecholamine release and hypertensive crisis. Because MAO enzyme activity recovers only after new enzyme synthesis, interaction risk persists after the last dose.2,1
Dosing & protocol.
May be taken with or without food. Patients must avoid foods and beverages with significant tyramine content during therapy and for 2 weeks after stopping.
Full safety detail.
Side effects
- Insomnia
- Orthostatic hypotension
- Dry mouth
- Constipation
- Sexual dysfunction
- Agitation or anxiety
- Hypertensive crisis with tyramine or sympathomimetics
- Serotonin syndrome with serotonergic combinations
- Withdrawal symptoms if stopped abruptly
Contraindications
- Hypersensitivity to tranylcypromine1,3
- Pheochromocytoma
- Cerebrovascular disease or cardiovascular disease where hypertensive crisis would be especially dangerous
- Concomitant MAOIs, serotonergic antidepressants, serotonin precursors, meperidine, tramadol, methadone, dextromethorphan, sympathomimetics, or St. John's Wort2
- Inability to follow tyramine-restricted diet and medication washout requirements1,3
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Reviews & position papers
2- 1TranylcypromineURLStatPearls Publishing · NCBI Bookshelf · 2025
Review emphasizes blood pressure monitoring, tyramine avoidance, and interaction washouts.
- 2The serotonin syndromeBoyer EW, Shannon M · New England Journal of Medicine · 2005
Combining serotonin-enhancing agents with impaired monoamine metabolism can cause severe serotonin toxicity.
Reference material
1- 3PARNATE (tranylcypromine sulfate) tablets, US Prescribing InformationURLAdvanz Pharma (US) Corp. · DailyMed · 2025
Labeling includes recommended 30 mg/day dosing, maximum 60 mg/day, suicidal thoughts warning, hypertensive crisis warning, and tyramine restrictions.
Common questions.
Quick answers about Tranylcypromine, drawn from the data on this page.
What is Tranylcypromine?
Tranylcypromine is an irreversible nonselective MAOI used for major depressive disorder when other antidepressants have not worked adequately. It requires strict management of tyramine intake, contraindicated medications, and washout periods because hypertensive crisis and serotonin syndrome can be life-threatening. It is not generally used as first-line antidepressant therapy because of these safety requirements.
What is Tranylcypromine used for?
Commonly cited benefits of Tranylcypromine include: Treatment-resistant major depressive disorder; Atypical depressive symptoms in selected patients; Depression not responding to SSRIs, SNRIs, TCAs, or other strategies. NutriStack rates the overall evidence as strong.
What is a typical dose of Tranylcypromine?
A typical adult dose of Tranylcypromine is Recommended daily dosage is 30 mg in divided doses; increase by 10 mg/day every 1 to 3 weeks if needed, up to 60 mg/day.. The commonly recommended form is Oral tablet with specialist supervision and tyramine-restricted diet. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Tranylcypromine?
Reported side effects include insomnia, orthostatic hypotension, dry mouth, constipation, sexual dysfunction, agitation or anxiety. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Tranylcypromine?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Tranylcypromine in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.