esketamine + tranylcypromine

Esketamine + tranylcypromine is a combination of two pharmaceutical agents used in the management of treatment-resistant depression. Esketamine is the S-enantiomer of ketamine and acts primarily as an NMDA receptor antagonist, producing rapid antidepressant effects. Tranylcypromine is a non-selective, irreversible monoamine oxidase inhibitor (MAOI) that increases synaptic concentrations of serotonin, norepinephrine, and dopamine by inhibiting their breakdown. While both drugs are individually approved for major depressive disorder—esketamine for treatment-resistant depression and acute suicidal ideation, and tranylcypromine for major depressive disorder—their combination has been considered potentially hazardous due to concerns about hypertensive crises from excessive monoaminergic activity. However, recent clinical data suggest that at standard doses this combination does not result in clinically significant adverse cardiovascular events; minor transient increases in blood pressure may occur but are generally asymptomatic[1][2][3]. Caution is advised with higher doses of tranylcypromine due to a dose-response relationship with blood pressure elevation[1].

Other names

S-ketamine + tranylcypromineEsketamine hydrochloride + tranylcypromine