PHENELZINE

Interactions with Herbs

Ephedra sinica (Ma huang)
Ephedra contains the chemical ephedrine, which may interact with phenelzine, causing potentially dangerous changes to blood pressure.² People should read product labels for ephedra/ephedrine content. Ephedra and ephedrine-containing products should be avoided during phenelzine therapy. People with questions about phenelzine and ephedra/ephedrine should ask their doctor or pharmacist.

Ginseng (species not specified)
In a case report of a woman treated with phenelzine, addition of a ginseng-containing tea was associated with insomnia, headache, and tremor.³ Other contents of the tea were not reported. In a case report of a woman treated with phenelzine for depression, addition of ginseng (not further identified) was associated with hypomania (a mild form of mania), which the patient had not previously experienced.⁴ Until more is known, people should combine ginseng and phenelzine with caution after consulting a knowledgeable doctor.

St. John’s wort (Hypericum perforatum)
Although St. John’s wort contains chemicals that bind MAO in test tubes, it is believed that the action of St. John’s wort is not due to MAOI activity.⁵ However, because St. John’s wort may have serotonin reuptake inhibiting action (similar to the action of drugs such as Prozac®, it is best to avoid concomitant use of St. John’s wort with MAOI drugs.

Scotch broom (Cytisus scoparius)
Scotch broom contains high levels of tyramine. Combining phenelzine and Scotch broom may cause MAOI-type reactions (diarrhea, flushing, sweating, pounding chest, dangerous changes in blood pressure, and other symptoms).⁶ It is important for people taking phenelzine to avoid Scotch broom. People with questions about phenelzine and Scotch broom should ask their doctor.