Phenelzine (Nardil)

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia</p>

<p>

Phenelzine is an irreversible and non–selective MAO inhibitor. In addition it increases the levels of GABA in some parts of the brain, which may explain why it is a powerful anxiolytic that provides relief even in some otherwise refractory cases. Phenelzine has shown efficacy in migraine prophylaxis.98 It is sometimes used to treat CFS/ME, with one study from 1996 supporting its efficacy for this use, though many patients dropped out prematurely because of side effects.99

The commonly recommended dosing regime of phenelzine differs from other antidepressants. It is initially started with 15 mg three times a day and titrated up to 60–90 mg a day. This dosage is maintained for at least four weeks, after which it can be dropped as low as 15 mg, every day or even every other day. These instructions may not be appropriate for people with CFS/ME. The aforementioned study only used at most 15 mg a day.

The most common side effects are dizziness, drowsiness, sleep disturbances (both insomnia and hypersomnia), fatigue, weakness, weight gain, orthostatic hypotension, constipation, dry mouth and stomach upset. Sexual problems are possible. The side effects usually markedly abate with time. Abrupt withdrawal of the drug can cause nausea, vomiting and malaise. Phenelzine can also reduce the blood levels of vitamin B6.

Phenelzine is available in the United States, United Kingdom, Canada, Australia and a few European countries. The price is quite affordable.</p>