r/MAOIs

Hi everyone,

I’m back again. I just really need some reassurance, hopeful stories, and a sense of recognition.

I’m almost 3 weeks into Parnate now. I know it’s still too early to judge, but the lack of improvement — actually more like it feeling worse (more despair, unbearable psychological suffering, suicidal thoughts) — is scaring me.

I’m not experiencing any side effects otherwise, and my blood pressure keeps checking out fine. Does that mean something bad? Has anyone here had a slow or rough start on Parnate that ended up working out well in the end?

Thanks in advance for reading and for sharing your stories.
🌻🌻🌻🌻🌻🌻

edit: I’ve now been hospitalized for a month to cross-taper from clomipramine to Parnate (tranylcypromine), under close psychiatric supervision.
- I started Parnate on July 31st, increased to 30mg fairly quickly
- 40mg on August 11th
- 50mg on August 14th

I want so badly to believe this medication can help me.. I need to let go and trust…

I (25M) don't take it yet, and I'm still considering because some of the dangerous aspects of it are a bit worrying to me. My psychiatrist who's very good recommend this to me and said there's almost nobody else around here that would prescribe it.

I've been on medications my whole life and nothing is getting through to my rigid brain as far as anxiety and depression and at this point I really want to experience feeling content with life. I don't see this being a super long term prescription to be filled realistically, and I'm just wondering if it still has lingering effects after stopping.

Your overall experiences would be great

Thank you!

This isn’t good. I’m generally a healthy person. Taking 75mg. Been on nardil about 3 months.

First couple months really didn’t have a problem with overeating. Mild cravings but nothing insane.

Did a keto diet for a few weeks up until last week, not for losing weight but losing the water weight/edema associated with nardil.

Well, last week, after a stressful day, I went and picked up some donuts. Said fuck it. Ate all 12. Since then I’ve been doing the same thing every night, and some days I’ve been eating as much as 10k calories, making myself sick but my mouth/body keeps wanting more.

Never dealt with binging on food like this. It’s bad. As you might imagine I’m gaining weight pretty rapidly. It’s like once I put something with carbs in my mouth, I just want more and more.

What are we doing to deal with this?

Yes it helped a lot with social anxiety when I first started, but tbh with a lot of life changes and new circumstances to be depressed about, 40mg didn't really seem to do anything anymore. I've been off parnate for a week, no brain zaps like I've had in the past when abrubtly stopping, yeah I'm depressed but not any more than I was on parnate. Is there a point in getting back on?

I guess the symptoms I'm dealing with now are feeling a bit more stupid but tbh I just lie in bed not doing shit until the adderall kicks in.

I (31F) previously was on Nardil 45mg for about a year and had physical side effects like hypotension and fatigue but loved what it did for my anxiety and mental health - felt like a new person!

When I got pregnant / was breastfeeding I came off and since then had wanted to try getting back on Nardil.

I ramped up pretty quick (to 45mg in a few days) just bc I knew I had done ok before but my experience this time was horrible - I had about a week of feeling absolutely foggy like (gaba overload?) Felt almost drunk / hazy / tired and then it was like a light switched and that haze lifted but I became SO anxious. Could hardly sleep and just felt like pure adrenaline overload 24/7. Was making me feel so panicked and emotional constantly that I didn’t make it past six weeks.

Why would I have such a different reaction? Has this happened to anyone else?

Hello. I have been suffering from major depression for about four years. I have tried every medication available. I was hospitalized for four months, underwent dozens of TMS sessions and dozens of ECT treatments (32 times), and received extensive therapy. I also underwent ketamine treatment. My illness began with a specific fear—the fear of losing my spouse (not fear of separation or death, but the fear of losing them). Suddenly, I lost myself; I was no longer who I used to be—I had become a stranger. I still feel that way. There is no issue with the motor region of my brain, but there is a problem in the emotional region. I have tried everything imaginable: religious rituals, healing waters, herbal remedies, sports, exercise, nutrition, supplements, and therapies. Incidentally, I cannot work because of this illness; I have no control over my brain. I constantly feel a deep sense of inner distress. I simply cannot regain my zest for life. I took 10 mg of Parnate for a week, 20 mg for a week, and 30 mg for about 12 days; however, for the past four days, I have been taking 20 mg because my supply is running low and I cannot obtain more. I did experience some benefit—I am able to handle my daily tasks—but the issues with low blood pressure and sleep have remained unchanged. My blood pressure drops significantly; although it doesn't happen constantly, occasional readings show 100/50 mmHg (systolic/diastolic), and I feel unable to even open my eyes. I wonder if I would see greater benefits if I could secure more medication and continue the treatment. Now, in a state of renewed hopelessness, I am considering trying Nefazodone.

I have started again on Parnate and have just gone from 10mg to 20mg daily after 3 days.
The problem is each dose only lasts 5 hours then it wears off , so I am only getting 10 hours a day of really good loss of social anxiety and depression. Then for the other 5 hours I don’t feel like doing anything and anxiety/ depression returns.
I used to be on 60mg. per day. Does anyone know why you can’t go up in dose faster ?
Especially when I was on 60mg. before and tolerated it fine ?

Hi everyone,

I’m a 29-year-old woman and I’ve been going through a severe depressive episode since June 2025. It started with a lot of mental unrest and rumination, and a growing sense of emotional flatness. At first I had hope this was temporary and that therapy, psychiatry, and a healthy lifestyle would get me through it. But over the following months I lost more and more of myself — like I wasn’t really “there.” Everything felt flatter, and despite sticking to therapy, medication, and a healthy routine, I kept getting worse instead of better.

I went from an SSRI to an SNRI, tried augmentation, then switched to clomipramine (a TCA) — each time hopeful that this would be the one that worked. I kept pushing myself to stay active, exercise, talk to people, but I felt more and more like an empty shell — not myself, not present, no relief or joy anywhere. Just surviving.

I also tried lithium, without benefit, and esketamine/Spravato this spring, which unfortunately didn’t have the effect I hoped for either. I kept telling myself: maybe next year, maybe when I go back to work, maybe with the next medication. The last few months have been a blur of crisis and growing hopelessness, but I’ve kept going, because I want so badly to get better — to feel present, to actually exist again.

It’s been months since I’ve felt even a flicker of hope or light.

I’ve now been hospitalized for a month to cross-taper from clomipramine to Parnate (tranylcypromine), under close psychiatric supervision. I started Parnate on July 31st, increased to 30mg fairly quickly, 40mg on August 11th, and 50mg on August 14th. It’s August 17th now, and I want so badly to believe this medication can help me. But:

• Is this too soon to give up hope, or is the wait genuinely not that long anymore?
• Is there still a real chance this could work?
• Does more patience make sense at this point?

I have no side effects so far, which honestly makes me anxious too — does that mean it’s not going to work? I’ll be speaking with my psychiatrist tomorrow.

Next week I’ll be doing pharmacogenetic testing (enzymes/DNA) to understand why I’m not responding to medication.

I feel like I’ve completely lost myself these past months — I’m unrecognizable from who I was over a year ago: functioning well (nice job, nice house) lively, driven, creative, social, someone who loved life and had plans and dreams.

I’m looking for something to hold onto — reassurance, stories of hope, anything that resonates. This can’t last forever, right?

One option I haven’t tried yet is rTMS, which I’d like to get a referral for.

Any experiences, stories, or words of encouragement would mean a lot to me right now.

Please let’s stay hopeful together!!!

Obviously, the sub gets a lot of questions. Just figured I'd share my experience and answer anything I can about how it has worked for me. Mental health is important, so I like to help where I can.

I am from Portugal and you don't have MAOIS.

My Last psychiatrist is spanish and tell me that he use in saindo, in the past Nardil for complex phobias(its the first one i hear that use MAOIS without problem.

Só i am borderline, depressivo, anxiety etc etc etc

I am asking if Nardil can be my last resort.

People who try it,it is really different?

Hi everyone,

I’m seeing my psychiatrist today to discuss the possibility of trying an MAOI. I’m dealing with treatment-resistant depression as well as severe anxiety.

Because anxiety is such a major part of my symptoms, I had initially assumed Nardil would be the MAOI to consider first. But after reading people’s experiences here, I’m not completely sure. It seems like Parnate can be very effective for anxiety as well.

For those of you who have had treatment-resistant anxiety, did Parnate help you? I’d really appreciate hearing about your experiences, especially if you’ve tried both Parnate and Nardil. I am also curious if Parnate generally has fewer side effects, particularly insomnia.

Thank you!

What are the pros and cons to getting to the max dose of 90mg? (in a very short time E.g 1 month after starting)

I have had treatment resistant depression for 2 years. I have tried Sertraline, duloxetine, mirtazapine, trintellix, TMS, Ketamine, Psilocybin, and I currently take Nortriptyline (TCA), lithium, and low dose quetapine. Like my previous attempts, it isn’t doing much, although, the best thing I have tried so far. I still feel depressed all time, and my psychiatrist have suggested to go with ECT or a MAOI (Marplan).

Would you go for the MAOI first despite the need for tapering and washout and did you have a similar series of trials before you got to a MAOI with depression? And of course, was it then helpful for you?

Me and my doctor are wondering about emsam 6mg to see if it can help my pleasureless orgasms and my complete loss of libido i have severe anhedonia i do not feel depressed i also have serious cognitive dysfunction anxiety loss of spontaneous thoughts and socializing. I don’t have any reaction to sexual thoughts not physically or mentally i have the feeling of knowing it should be pleasurable and i want to do it but no reaction no feeling of libido

Been following this page for a while and finally started phenelzine/Nardil 8 weeks ago…

It’s actually working!! Amazingly. For anxiety and MDD.

Started working at about 5/6 weeks when I reached 60mg.

Most annoying side effect is urinary retention and anorgasmia. No insomnia or weight gain. A little bit of hypotension and jaw clenching. No hypomania.

This drug is amazing. My emotional range is expanded, I feel so much happier and more connected, more confident, relaxed. Like the best version of myself. The best part is that I don’t necessarily “feel” it. It’s like it’s just changed me deeply.

Just wanted to share!

Has anyone here experienced persistent symptoms—such as anhedonia, no feelings, muscle spasms, internal akathisia—caused by SSRIs or SNRIs, and found relief for these issues by using an MAOI?

SSRIs and SNRIs caused me several problems: a loss of sensation, no feelings, tension in muscles throughout my entire body, internal agitation, chronic fatigue, and anhedonia.

would you think that MAOI can help with that?

Did Emsam help your anhedonia at all? If you had to rate it 1-10 overall for your depression & or anhedonia where would you put it? Did it poop out over time for anyone after consistently using it?

28 yo w/ ADHD-PI, PTSD, OCD, Social Anxiety, Panic Disorder, and MDD.

I've tried many, many medications without much success. SSRI's tend to simply make me feel flat w/o helping anything, while adrenergic compounds like Bupropion, ADHD stimulants, and even SNRI's tend to worsen my panic/somatic symptoms. A2A's somewhat help my anxiety, but worsen my mood/depression.

I'm at a crossroads and don't know what to do. I found an outside provider (out of network) that is open to prescribing an MAOI (Nardil/Parnate), but I also have the option of trying to get TMS/Spravato covered by my insurance (Kaiser).

Obviously, each have their drawback. It may be difficult to get TMS/Spravato covered right away, and MAOI's come with dietary and medication interactions/adjustments.

Thing is, I can't really have two psychiatrists at once (Kaiser vs out-of-network).

Thoughts?

Thank you so much 🙏 🙏

Met with a new psych and managed to talk her into prescribing me Nardil even though she clearly has little to no experience with it and doesn't know much about them. I asked to start at 45 but she went straight to prescribing me 60 for some reason. Anyone else ever do this or is that too much too soon?

I’ve tried to get an irreversible MAOI, specifically Phenelzine, on the NHS for slightly under fifteen years due to social anxiety. I’m currently on 600mg daily of Moclobemide. I’ve been on it for two years, and it’s the first antidepressant to touch social anxiety, though it only offers some relief about half of the time, and its effects don’t last all day. There’s definitely a drop in its effects between morning and evening doses that starts sometime after lunch and lasts until dinnertime, when I take the second dose. There are many occasions where it does absolutely nothing.

Personally, I’ve partially come to accept that Moclobemide is the best medication I will get on the NHS for social anxiety, or rather I’ve given up asking for anything more effective as I know the answer will be no. I’m unemployed due to anxiety, and not on benefits, and it's difficult when your life is in tatters while knowing that there’s a medication such as Phenelzine that could potentially help you turn things around, but you're unable to access it.
For context, I’ve tried Sertraline, Venlafaxine, Mirtazapine, and combined Sertraline and Mirtazapine, all up to their respective maximum doses. I’ve also tried years of CBT and exposure therapy.

Given that I do experience partial relief on Moclobemide some of the time, am I being ungrateful? Should I fully accept that this is the best I can do medication-wise?