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Subject:
From:
"Dr. Tom Hale" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 28 Jul 1999 10:45:03 -0400
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To : Trudy Noort
Re : Nardil ( phenelzine)

Phenelzine is a potent, irreversible inhibitor of Monoamine oxidase, the
enzyme in humans that breaks down catecholamines such as epinephrine,
dopamine, serotonin, and norepinephrine.

While it is a good antidepressant, it has so many dangers associated with
its use, that most physicians would never consider using it.

Many foods that contain tyramine or tryptophan, nasal decongestants, and
hundreds of other foods and medications cannot be ingested by patients using
this drug or you risk a severe and life-threatening hypertensive crisis.

Because this drug inhibits MAO irreversibly, any small amount ingested via
breastmilk could be extremely hazardous to an infant.  Therefore, I would
not recommend that a mom use this drug and breastfeed.  Although we have no
data on its transfer to milk,  any present in milk could be hazardous.

As we have dozens of other good antidepressants (excluding Prozac), why not
suggest she convert to one of these prior to breastfeeding.  If she does
convert, she must wait a minimum of 2-3 weeks prior to taking anything
new...so that her body will resynthesize MAO.  Otherwise you risk a severe
serotonergic syndrome.

Regards

Tom Hale, Ph.D.

http://neonatal.ttuhsc.edu/lact/

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