Tranylcypromine
Parnate
Also known as: Nardil
LIFE-THREATENING: MAOIs + ibogaine serotonergic activity = fatal serotonin syndrome and hypertensive crisis.
Severity
Contraindicated
Mechanism
Monoamine oxidase inhibition
Protocol Status
Pre-arrival washout (under your prescribing physician)
Restart Delay
21 days
What "Contraindicated" Means
Absolute prohibition without an enforced washout. Treatment cannot proceed safely until the medication has been cleared from the body for the protocol's required interval.
Clinical Action
MUST discontinue minimum 14 days before treatment. Non-negotiable.
Where the Washout Happens
Pre-arrival washout (under your prescribing physician)
Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose.
Pre-Treatment Washout Window
14 days minimum before treatment.
Post-Treatment Restart
Wait at least 21 days post-treatment before restarting.
The Pharmacology
MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, moclobemide, ayahuasca) prevent breakdown of serotonin, dopamine, and norepinephrine. Combined with noribogaine's serotonergic activity, the result can be fatal serotonin syndrome and hypertensive crisis. This is an absolute contraindication with the longest enforced washout in the protocol.
Same Mechanism
Same Severity Tier
Serotonergic activity (serotonin syndrome)
Prozac, Sarafem
Serotonergic activity (serotonin syndrome)
Zoloft
Serotonergic activity (serotonin syndrome)
Paxil, Pexeva
QT-interval prolongation
Celexa
QT-interval prolongation
Lexapro
Serotonergic activity (serotonin syndrome)
Luvox
Common Questions
Contraindicated. LIFE-THREATENING: MAOIs + ibogaine serotonergic activity = fatal serotonin syndrome and hypertensive crisis. MUST discontinue minimum 14 days before treatment. Non-negotiable.
Pre-arrival washout (under your prescribing physician). Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose. 14 days minimum before treatment. Wait at least 21 days post-treatment before restarting.
Monoamine oxidase inhibition. MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, moclobemide, ayahuasca) prevent breakdown of serotonin, dopamine, and norepinephrine. Combined with noribogaine's serotonergic activity, the result can be fatal serotonin syndrome and hypertensive crisis. This is an absolute contraindication with the longest enforced washout in the protocol.
In many cases yes. Our medical team works with your prescribing physician to taper or substitute medications safely before treatment. The right substitution depends on the underlying condition you are treating with Phenelzine — contact us for an individual review.
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