By vgreene, 5 October, 2020 Monitor therapeutic plasma concentrations for desipramine (125-300 ng/mL), imipramine (200-350 ng/mL), & nortriptyline (50-175 ng/mL) to limit risk of toxicity
By vgreene, 5 October, 2020 Use w/ caution & disperse in limited quantities in pts at risk for suicide d/t ↓lethal dose threshold compared to SSRIs
By vgreene, 5 October, 2020 Can uarr intraocular pressure in persons w angle closure glaucoma orthostatic hypotension syncope tachycardia arrhythmias
By vgreene, 5 October, 2020 Tolerability is limited by sedation anticholinergic effects dry mouth eyes constipation cognitive slowing or impairment urinary retention
By vgreene, 5 October, 2020 Requires adequate wash out period following tx w other antidepressants drugs that interact w MAOIs based on half life
By vgreene, 5 October, 2020 Avoid use w/ stimulants, vasoconstrictors, other meds w/ adrenergic effects d/t potential for hypertensive crisis
By vgreene, 5 October, 2020 Requires dietary restriction of tyramine highly concentrated amine containing foods to avoid hypertensive crisis except for lowest strength of the selegiline transdermal patch
By vgreene, 5 October, 2020 Refer tx resistant1 pts to mental health specialist for other pharmaco tx options incl MAOIs TCAs or repetitive transcranial magnetic stimulation rTMS per VA 1 ICSI says to combine drugs w therapy notes that MAOIs may be particularly effective for MDD pts
