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Antidepressant medications, such as phenelzine (Nardil), are prescribed to treat depression and other mood disorders. While they can offer significant benefits, they also come with potential risks that need careful consideration. Below are key safety and warning details:

• Risk of Suicidal Thoughts or Behavior: Especially in individuals 24 years or younger, there is an increased risk of worsening depression or suicidal thoughts, particularly during the initial weeks of treatment or when adjusting the dosage. Close monitoring for any changes in mood or behavior is crucial. Contact your healthcare provider if you notice new or worsening symptoms such as anxiety, panic attacks, trouble sleeping, irritability, or impulsive actions.

• Bipolar Disorder Considerations: Phenelzine (Nardil) should not be used alone in individuals with bipolar disorder, as it may trigger a manic episode. Discuss your complete medical history with your healthcare provider to determine the best treatment plan.

• High Blood Pressure Risk: Although rare, phenelzine can cause a dangerous increase in blood pressure, especially if consumed with foods high in tyramine (such as aged cheese, cured meats, or pickled foods) or certain beverages. It is important to discuss dietary restrictions with your healthcare team.

• Serotonin Syndrome: There is a risk of developing serotonin syndrome, a potentially life-threatening condition, when phenelzine is taken with other medications that increase serotonin levels, including some antidepressants. Ensure all your healthcare providers are aware of your current medication list to prevent harmful interactions.

In certain situations, phenelzine should not be used due to the risk of serious health issues:

• Contraindications: Avoid using phenelzine if you have heart failure, severe kidney or liver issues, pheochromocytoma, or are undergoing surgery with general anesthesia. Do not combine phenelzine with alcohol, meperidine, certain opioids, stimulant medications, or drugs that affect serotonin levels, including buspirone and bupropion.

Should you experience an overdose, seek immediate medical attention. Always consult with your healthcare provider to discuss potential risks and ensure that phenelzine is safe for you, especially if you have any pre-existing health conditions or are taking other medications.

When taking this medication, some common side effects may include dizziness, drowsiness, tiredness, weakness, and trouble sleeping. You might also experience constipation, dry mouth, and shakiness. While these effects are typically mild, it's important to contact your healthcare provider if they persist or worsen. Additionally, some people may notice weight gain, swelling, or sexual health issues, such as erectile dysfunction or problems with orgasms. To minimize dizziness or lightheadedness, try rising slowly from sitting or lying positions.

Occasionally, users report blurry vision, uncontrollable eye movements, itchiness, sweating, feeling jittery, numbness, or tingling. In rare cases, there might be bladder issues or repeating words. Although these are less common, if they occur, consulting with a healthcare professional is advisable.

More serious side effects, though rare, demand immediate medical attention. These include suicidal thoughts, extremely high blood pressure symptoms like seizures, chest pain, severe headaches, confusion, or blurred vision. Serotonin syndrome is another serious condition to be aware of, characterized by hallucinations, seizures, confusion, restlessness, shivering, excessive sweating, high fever, a racing heart, muscle stiffness, or twitching. Lastly, rare allergic reactions can occur, marked by rash, itching or swelling of the face, tongue, or throat, dizziness, or trouble breathing. If you notice any of these severe symptoms, seek urgent medical care.

Phenelzine, also known as Nardil, may interact with various medications and substances. It's crucial to inform your doctor and pharmacist about all the medications and supplements, whether prescribed or over-the-counter, that you are currently using.

Critical Drug Interactions:

1. Antidepressants and Psychostimulants: Phenelzine can interact with other antidepressants like amitriptyline, nortriptyline, maprotiline, mirtazapine, and nefazodone, as well as stimulants such as amphetamines and methylphenidate. These combinations can lead to serious conditions like serotonin syndrome or increased blood pressure.

2. Appetite Suppressants and ADHD Medications: Drugs used for weight loss (e.g., diethylpropion) and attention deficit disorder (e.g., atomoxetine) can also interact, potentially increasing side effects.

3. Blood Pressure and Parkinson’s Medications: Certain blood pressure medications (like guanethidine, methyldopa) and Parkinson’s treatments (such as levodopa) may cause heightened side effects when taken with phenelzine.

4. Opioids and Muscle Relaxants: Opioid pain relievers (e.g., fentanyl, meperidine) and muscle relaxants (e.g., cyclobenzaprine) should be used cautiously due to the risk of drowsiness and other adverse effects.

5. MAO Inhibitors and Other Serotonergic Drugs: Other Monoamine Oxidase Inhibitors (e.g., isocarboxazid, linezolid) can increase the risk of serotonin syndrome, especially if dosages are started or increased.

6. Dietary and Herbal Supplements: St. John's Wort, certain herbal supplements, and foods high in tyramine (like aged cheeses and processed meats) can cause severe reactions, including dangerously high blood pressure.

Dietary Considerations: Avoid foods and beverages with high tyramine content while on phenelzine and for at least two weeks after stopping. This includes certain cheeses, processed meats, and beverages like red wine and tap beer. Caffeine should also be consumed in moderation to prevent increased side effects.

Symptoms to Watch For: If you experience symptoms such as a rapid heartbeat, severe headache, or sudden vision changes, contact your healthcare provider immediately. These could indicate high blood pressure or serotonin syndrome.

Always consult your healthcare provider when starting or stopping any medication to ensure safety and efficacy.