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Antidepressant medications are prescribed for depression and various other mental health conditions. While these drugs can significantly reduce the risk of suicidal thoughts and provide numerous benefits, there is evidence suggesting that a small percentage of individuals, particularly those under 25, may experience increased depression or other psychological symptoms when using antidepressants. Discussing the potential risks and benefits with a healthcare provider is crucial, especially for those under 25, regardless of whether the treatment is for a mental health condition.

Important points to consider:

• Immediately inform your doctor if you observe any signs of worsening depression or other psychiatric changes, such as unusual behavior or new suicidal thoughts. Other symptoms to watch for include increased anxiety, panic attacks, sleep disturbances, irritability, anger, impulsive behavior, extreme restlessness, or rapid speech.
• Be particularly vigilant for these symptoms when starting a new antidepressant or adjusting the dose.
• There is a rare risk of experiencing a hypertensive crisis, a condition of extremely high blood pressure that can be life-threatening. This risk is heightened by interactions with various drugs and tyramine-rich foods and beverages.
• Regularly monitor your blood pressure.
• Provide your doctor and pharmacist with a complete list of all medications and supplements you are currently taking before starting treatment with tranylcypromine.
• Consult with your healthcare provider before beginning or discontinuing any medications while on tranylcypromine, as interactions can persist even after stopping the medication.

Following these guidelines ensures safe and effective use of antidepressants while minimizing potential risks.

You may experience mild side effects such as dizziness, drowsiness, tiredness, weakness, difficulty sleeping, constipation, and dry mouth. These are generally manageable, but if they persist or worsen, it is important to consult your healthcare provider. To minimize dizziness and lightheadedness, try standing up slowly when moving from sitting or lying down.

There are more serious side effects that, although less common, require immediate attention. Contact your healthcare provider if you experience fainting, significant mood or mental changes (like agitation or confusion), muscle stiffness, altered sexual interest or ability, tremors, shivering, swelling in the ankles or legs, unexpected weight gain, eye pain, redness or swelling, changes in vision, or signs of liver issues such as persistent nausea, vomiting, abdominal pain, yellowing of the skin or eyes, and dark urine.

In rare instances, this medication can cause dangerously high blood pressure, known as a hypertensive crisis. Seek emergency help if you encounter severe headaches, irregular heartbeat, chest pain, neck stiffness, severe nausea, sweating, fever, wide pupils, or sudden sensitivity to light.

This drug may increase serotonin levels, potentially leading to serotonin syndrome, a serious condition. Risk increases if combined with other serotonin-enhancing drugs. Symptoms include rapid heartbeat, hallucinations, loss of coordination, severe dizziness, intense nausea, muscle twitching, unexplained fever, and agitation. Immediate medical attention is necessary if these occur.

Allergic reactions to this medication are rare but can be severe. Get emergency help if you notice symptoms like rash, swelling of the face, tongue, or throat, severe dizziness, or difficulty breathing. If you experience any side effects not listed, contact your healthcare provider for guidance.

Some medications may interact with this drug, including other antidepressants like Maprotiline, Mirtazapine, Nefazodone, and tricyclics such as Amitriptyline or Nortriptyline; appetite suppressants like Diethylpropion; medications for attention deficit disorder such as Atomoxetine and Methylphenidate; Apraclonidine; bupropion; Buspirone; Carbamazepine; Cyclobenzaprine; deutetrabenazine; dextromethorphan; certain blood pressure medications including guanethidine, Methyldopa, and beta blockers like Atenolol, Clonidine, and rauwolfia alkaloids; other MAO inhibitors like isocarboxazid, Linezolid, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, and Selegiline; specific opioids such as Fentanyl, methadone, and tapentadol; Metoclopramide; drugs for Parkinson's disease such as Entacapone, Levodopa, and Tolcapone; s-adenosyl-L-methionine (SAM-e); illicit drugs like LSD and mescaline; stimulants such as amphetamines, cocaine, dopamine, Epinephrine, and Phenylalanine; Tetrabenazine; "triptan" migraine medications such as Sumatriptan and Rizatriptan; Tramadol; Tyrosine; Tryptophan; valbenazine. Taking these can increase the risk of serotonin syndrome/toxicity, especially if you start or increase the dosage of these drugs. This risk is elevated with drugs that boost serotonin, including street drugs like MDMA/"ecstasy," St. John's wort, and certain antidepressants like SSRIs (e.g., Fluoxetine, paroxetine) and SNRIs (e.g., Duloxetine, Venlafaxine), as well as Meperidine.

Before, during, or within two weeks of using tranylcypromine, inform your doctor or pharmacist if you are taking any of these medications. If you have taken fluoxetine, inform them if it was within at least five weeks before starting tranylcypromine. Discuss with your doctor how long to wait between starting or stopping any of these drugs and using tranylcypromine.

Let your healthcare provider know if you are taking other products that may cause drowsiness, such as opioid pain or cough medications like codeine and hydrocodone, alcohol, marijuana (cannabis), sleep or anxiety medications like Alprazolam, Lorazepam, and Zolpidem, muscle relaxants like Carisoprodol and cyclobenzaprine, or antihistamines like Cetirizine and diphenhydramine.

Examine the labels of all your medications, including allergy, cough-and-cold products, and diet pills, as they may contain dextromethorphan, decongestants, stimulants, or ingredients that cause drowsiness. Consult your pharmacist about the safe use of these products.

It's crucial to follow specific dietary restrictions to limit tyramine intake. Avoid consuming large quantities of Caffeine (found in coffee, tea, and colas) or chocolate, as caffeine can heighten the side effects of this medication. Avoid foods and beverages high in tyramine while taking this medication and for at least two weeks after discontinuation.

Foods high in tyramine include aged cheeses, aged or processed meats and fish, banana peel, stored beef/chicken liver, bouillon cubes, commercial gravies, concentrated yeast extracts, fava beans, fermented bean curd, homemade yeast-leavened bread, kimchee, orange pulp, overripe or spoiled fruits, packaged soups, red wine, sauerkraut, sherry, snow pea pods, sourdough bread, soy sauce, soybeans, soybean paste/miso, tofu, tap beer and ale, and vermouth.

Foods with moderate-to-low tyramine content include alcohol-free beer, avocados, bananas, bottled beer and ale, chocolate, coffee, cola, cultured dairy products, distilled spirits, eggplant, canned figs, fish roe, green bean pods, pate, peanuts, port wine, raisins, raspberries, red plums, spinach, tomatoes, and white wine.

Immediately inform your doctor or pharmacist if you experience symptoms of high blood pressure such as a rapid or slow heartbeat, vomiting, sweating, headache, chest pain, sudden vision changes, weakness on one side of the body, or difficulty speaking.

For further information, including dietary recommendations, consult your healthcare professionals such as a doctor, pharmacist, or dietician.