Sedatives & Hypnotics
MAOIs (Phenelzine, Tranylcypromine, Moclobemide)
Street names: Nardil, Parnate, Phenelzine, Tranylcypromine, Moclobemide, Marplan
Overdose? Act now. Call emergency services — say "unresponsive, not breathing". Give naloxone for opioid-like signs. Hotlines
⚡What it does
- The strongest antidepressants for atypical depression — irreversible (Nardil/Parnate) or reversible (moclobemide) monoamine oxidase inhibition
⚠Key risks
- TYRAMINE CRISIS: aged cheese, cured meats, tap beer, fermented soy → hypertensive crisis (stroke-level BP) — the classic interaction
- SEROTONIN SYNDROME with SSRIs, MDMA, tramadol, dextromethorphan, St John's Wort — potentially fatal; washout rules (2 weeks for irreversibles)
- The reason 'meperidine + MAOI' is a lethal combination (searched query)
- Insomnia, weight gain, orthostasis
- Under-prescribed from fear — but real tools with real rules
✚Overdose signs
- Severe headache, BP spike (tyramine)
- Agitation, clonus, fever (serotonin)
- Consciousness changes
Category comparison — Sedatives & Hypnotics
| Substance | Class | Top risks | Street price |
|---|---|---|---|
| MAOIs (Phenelzine, Tranylcypromine, Moclobemide) | Rx-only — not controlled | TYRAMINE CRISIS: aged cheese, cured meats, tap beer, fermented soy → hypertensive crisis (stroke-level BP) — the classic interaction; SEROTONIN SYNDROME with SSRIs, MDMA, tramadol, dextromethorphan, St John's Wort — potentially fatal; washout rules (2 weeks for irreversibles) | ~$0.50–$2 per tablet |
| Zolpidem (Ambien/Stilnox) | Schedule IV | Sleep-walking, sleep-driving, hallucinations; Dependence and rebound insomnia | ~$2–$10 per 10 mg tablet |
| Secobarbital (Seconal) | Schedule II | Barbiturates: tiny margin between dose and death; Fatal in overdose, brutal withdrawal (seizures) — replaced by benzos in medicine | ~$15–$40 per capsule where diverted |
| Carisoprodol (Soma) | Schedule IV | Converts to meprobamate (Miltown) — dependence; Popular 'Soma Coma' mix with opioids — deadly | ~$1–$8 per 350 mg tablet |
| Cyclobenzaprine (Flexeril) | Not scheduled | Overdose causes hallucinations, seizures, heart rhythm problems; Abuse usually in combination (potentiates opioids) | ~$1–$5 per 10 mg tablet |
| Pentobarbital (Nembutal) | Schedule II | Veterinary euthanasia drug — overdose is usually fatal; Narrow safety margin (barbiturate) | ~$30–$100+ per vial/capsule-equivalent |
Street prices are regional estimates. Potency and cuts vary constantly.
?Frequently asked questions
What does MAOIs (Phenelzine, Tranylcypromine, Moclobemide) look like?
Tablets (15 mg phenelzine, 10 mg tranylcypromine, 150–600 mg moclobemide)
What are the signs of a MAOIs (Phenelzine, Tranylcypromine, Moclobemide) overdose?
Severe headache, BP spike (tyramine); Agitation, clonus, fever (serotonin); Consciousness changes Call emergency services immediately.
How addictive is it?
TYRAMINE CRISIS: aged cheese, cured meats, tap beer, fermented soy → hypertensive crisis (stroke-level BP) — the classic interaction Dependence can develop with regular use.