Phenelzine

Phenelzine is reserved for use by specialists, or practitioners familiar with managing associated dietary restrictions and drug interactions (see Principles of using irreversible nonselective monoamine oxidase inhibitors [MAOIs]). Lower doses may be needed in older people; consult a source of drug information.

If phenelzine is considered appropriate for treatment-resistant PTSD, a suitable regimen is:

phenelzine 15 to 30 mg orally, daily in 2 divided doses (the last dose each day should be given no later than early afternoon to minimise insomnia)¹. Assess the patient’s response to therapy after 2 to 4 weeks to determine whether dose adjustment is needed. If it is, increase the daily dose by 15 mg no more often than every 2 weeks until an acceptable response is achieved or a daily dose of 90 mg is reached. Continue treatment for at least 8 to 12 weeks. If there is an acceptable response, continue at the same dose for 12 months, then consider deprescribing. phenelzine phenelzine phenelzine

¹ Although three times daily dosing is recommended in other resources, twice daily dosing is preferred in these guidelines in line with phenelzine’s use in practice.Return