Nardil

Nardil is the brand name for phenelzine, an irreversible non-selective monoamine oxidase inhibitor (MAOI) antidepressant. It is prescribed for major depressive disorder that has not responded to other treatments and for panic disorder; it has also been used for atypical depression and certain anxiety disorders.

Phenelzine works by inhibiting monoamine oxidase A and B, increasing brain levels of monoamines such as norepinephrine, serotonin, and dopamine. This broader mechanism can help improve mood and related symptoms, but it also raises the risk of serious drug and food interactions compared with other antidepressants.

Dietary restrictions are a key aspect of MAOI treatment. Because MAOIs impede tyramine metabolism, patients must avoid high-tyramine foods to reduce the risk of hypertensive crisis. Restricted items commonly include aged cheeses and cured meats, processed or fermented foods, certain pickled or smoked fish, fava beans, some soy products, and some beers and wines.

Interactions with other drugs are a major safety concern. Serious interactions can occur with selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), meperidine, dextromethorphan, and other agents that affect serotonin or blood pressure. Risk of serotonin syndrome or hypertensive crises necessitates washout periods when switching from or to other antidepressants, and close medical supervision is required.

Administration is oral, with dosing individualized and typically titrated to reach an effective daily dose of roughly 60–90 mg divided across the day. Onset tends to be slower than with many other antidepressants, and patients require ongoing medical and dietary monitoring. Nardil remains a non-first-line option reserved for treatment-resistant cases or specific anxiety-related conditions.