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Q
My mother is going to be starting to take Nardil on Friday and I have heard so many things about it being dangerous (i.e. drug/food interactions). She has taken many different antidepressants including paxil, prozac, zoloft, amytriptyline, pamelor etc. over the past ten years with little success and the psychologist she sees thinks that maybe this type of drug will work. How successful has this drug been in treating patients who don't seem to respond well to other antidepressants and do the benefits outweigh the risks? Also, myself and my sisters are taking Paxil and since depression does seem to have genetic origin why wouldn't the same drug work for her?
A
... sorry to hear about your mother.
From your description, your mother has already been treated by two of the three major groups of antidepressant drugs,'tricyclics' and 'serotonin reuptake inhibitors', presumably with little or incomplete success. The latest, Nardil (phenelzine), belongs to a group of 'monoamine oxidase inhibitors' which have been around for quite a while. Currently their place is in treating patients such as your mother with inadequate response or intolerance to the others. Like all antidepressant therapy, success is hard to predict, but good results have been obtained. All drug treatments have their risks and the only thing you can say is that this drug has been around for so long that on the average the benefits have outweighed the risks.
You're right about interactions with other drugs and certain foods ... your mother's physician should have supplied her with a detailed list. Anyway for the time being here is a list of foods involved:
natural or aged cheeses
yogurt
beer and wine
pickled herrings
snails
chicken liver
yeast or yeast products such as soya
sauce
large quantities of coffee
citrus fruits
canned figs
broad beans
chocolate and cream or their products.
- this list is likely incomplete -
The average meal with any one of these would produce a marked rise in blood pressure and other cardiovascular changes. The greatest and perhaps most serious reaction would come from aged cheeses and yeast products such as food supplements. There are also reactions between Nardil and other drugs - in fact, your mother would be advised to avoid any other medication without professional advice. Here are some OTC drugs to avoid:- any cold remedy containing decongestants, usually -
pseudoephedrine,phenylephrine,or phenylpropanolamine.any cough remedy containing dextromethorphan.
Should your mother require any minor outpatient surgery, she cannot be given Demerol (meperidine).
Incidentally, about half the population in USA and Europe handle Nardil (and some other drugs) differently from the rest, with resultant variation in response - this is taken into account when establishing the proper dose. The usual daily dose is 15-30 mg. with extremes of 15-90 mg. If your mother was being treated with a tricyclic antidepressant, she should have had a 2-3 week rest before starting on the Nardil.
Don't forget, you have only half your mother's genes - even if depression (which is one word for many different syndromes) has a genetic origin it's more than likely your responses will be different.
Best wishes to you and your mother.
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