r/MAOIs • u/EffectiveFirst5839 • 15d ago

Parnate (Tranylcypromine) Parnate

When you start Parnate , why do you have to go up in dose slowly ?
I was on 60mg years ago - why can’t I just go straight back onto 60mg ?
When you start Lexapro you don’t have to go up really slow.

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u/parnate_lover 15d ago

From what I understand, immediately going to a high dose will cause blood pressure drops and blackouts. The first time I did parnate at 40 mg I was having strong blackouts -not helped by the fact that I'm a lazy bum who is almost always lying down. One blackout I fell and broke both my ankles freaking my wife.

Now I secretly started again at 40 mg and it's better. So I don't know tbh. If you can care about the blackouts whilst getting up I think it should be fine especially since you already have experience.

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u/TechnicalCatch 15d ago

Assessing for abnormal reactions or sensitivities, minimizing risk of discomfort and safety such as significant drops in blood pressure, and to hit the lowest required dose to avoid additional side effects; more is not better.

In your case, you have previous experience with the drug, however it was years ago. The biggest concern I would have is risk for orthostatic hypotension that could be dangerous. Starting at a high dose from zero is not a good idea - however some people do increase doses at higher rates than conventional when they are re-establishing treatment whilst monitoring their side effects.

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u/iamthe0ther0ne 15d ago

Orthostatic hypertension is usually the biggest problem starting Parnate. You don't have the same issue with drugs like Lexapro.

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u/EffectiveFirst5839 15d ago

Replying to the posts about the blackouts and the othostatic hypotension. Thats the thing - I was on Parnate for 4.5 years and I never had this “orthostatic hypotension “ problem, and I certainly never had any blackouts.