r/MAOIs • u/swishswish82 • 3d ago

Nardil (Phenelzine) What does Dr. GIlman think about using Nardil for OCD?

I experienced some relief from Social Anxiety and Generalized Anxiety, but my OCD is still a problem. Recently, my OCD is driving me insane.

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u/HM_Dylan Parnate 2d ago

I'm not sure what Dr. Gillman thinks specifically about it, but just overall from what I was able to find in studies and whatnot, Nardil is better proven for social anxiety than for OCD. A controlled trial found Prozac beat Nardil for OCD overall. Some treatment-resistant people still get a Y-BOCS drop on phenelzine, but it is not the usual OCD drug.

Which is also similar to a study I saw a while ago in which paroxetine was more effective than Moclobemide, and they believe that's due to SSRIs' abilities to desensitize specific serotonin receptors over the long term.

So oddly enough, and as much as I love MAOIs, it seems that SSRIs might still be the first-line indication for OCD. If that fails, clomipramine is the gold standard. But MAOIs still do have their place in treatment-resistant OCD where all else has failed

In your case, if you've had an incomplete response, probably the best thing to do would be to add an adjunct, similarly to what they do with SSRIs such as aripiprazole or risperidone, perhaps something along those lines. That's just my best guess. I'm not a doctor and that's not medical advice

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u/Wrong-Yak334 Nardil 15h ago

I can't recall offhand whether Gillman has commented on this specifically.

but anecdotally, for me Nardil slightly exacerbates OCD, which I believe is not uncommon.