phenelzine + trimipramine

Phenelzine + trimipramine is a combination of two antidepressant medications used in select cases of treatment-resistant depression. Phenelzine is a non-selective, irreversible monoamine oxidase inhibitor (MAOI) that increases brain levels of serotonin, norepinephrine, and dopamine by inhibiting their breakdown. Trimipramine is a tricyclic antidepressant (TCA) with unique properties among TCAs; it inhibits the reuptake of norepinephrine and serotonin but also has significant antihistaminic, anticholinergic, and antidopaminergic effects. The combination may be considered for patients who have not responded to monotherapy with either agent or other standard treatments. While some case reports and small studies suggest efficacy without major complications in carefully selected patients under close supervision, this regimen carries significant risks—including hypertensive crisis and serotonin syndrome—due to pharmacodynamic interactions between MAOIs and TCAs[1][5]. This combination should only be used when synergistic antidepressant therapy is indicated for refractory depression under specialist care.

Other names

phenelzine and trimipraminephenelzine plus trimipramine