Trivon Tablet – Tranylcypromine

Trivon is een tranylcypromine tablet gebruikt voor de behandeling van depression, particularly forms that have not improved with newer antidepressants. Each tablet contains 10 mg of tranylcypromine sulfate. It belongs to the oldest class of antidepressants — the monoamine oxidase inhibitors (MAOIs) — and is the generic equivalent of Parnate^®.

Tranylcypromine is reserved for treatment-resistant depression (TRD) en atypical depression (depression with mood reactivity, increased sleep and appetite, leaden paralysis, and rejection sensitivity), where MAOIs are often more effective than SSRIs. Its structure is related to amphetamine, which gives it a mild activating, energising quality some patients find helpful for low energy and anhedonia.

What Is Trivon (Tranylcypromine)?

Trivon is an MAOI antidepressant that irreversibly inhibits the enzyme monoamine oxidase (both MAO-A and MAO-B). By blocking the enzyme that breaks down monoamine neurotransmitters, it increases the available pool of serotonin (5-HT), noradrenaline (norepinephrine), en dopamine in the brain.

Trivon is most commonly used for:

• Treatment-resistant major depression — depression that has failed two or more adequate trials of other antidepressants
• Atypical depression — mood reactivity, hypersomnia, increased appetite, and rejection sensitivity, where MAOIs have historically shown superior response
• Depression with marked anergia and anhedonia — its mild stimulant character can help with low drive and motivation

How Does Trivon Work?

Tranylcypromine acts as a non-selective, irreversible monoamine oxidase inhibitor:

• It binds to and permanently inactivates both MAO-A en MAO-B, the enzymes that metabolise serotonin, noradrenaline, dopamine, and dietary amines such as tyramine
• Because the inhibition is irreversible, the effect lasts until the body synthesises new enzyme — which takes roughly 1–2 weken after the last dose
• The resulting rise in synaptic monoamines is thought to underlie its antidepressant effect, especially in atypical and treatment-resistant presentations
• Its cyclopropylamine structure is related to amphetamine, contributing a mild stimulant-like activating effect

Antidepressant benefit usually begins within 1–3 weeks, with full effect over 4–6 weken. Because MAO-A inhibition also reduces breakdown of dietary tyramine, een tyramine-restricted diet is mandatory throughout treatment and for two weeks after stopping.

Toepassingen en Indicaties

• Treatment-resistant major depressive disorder — a recognised option after multiple failed antidepressant trials
• Atypical depression — a historically strong indication for MAOIs
• Depression with prominent low energy, hypersomnia, and anhedonia

Trivon Dosage and Administration

How to Take Trivon Properly

• Take with or after food to reduce stomach upset
• Take the last dose by early afternoon to avoid insomnia
• Follow the tyramine-restricted diet strictly — see the dietary warning below
• Do niet take any other antidepressant, opioid, cough/cold remedy, or stimulant without checking with your prescriber
• Wacht 1–3 weeks for early response and up to 6 weeks for full effect
• Do not stop abruptly; taper under medical supervision
• Carry a card or note stating that you take an MAOI, in case of emergency treatment

Side Effects of Trivon

Orthostatic hypotension (dizziness on standing) is one of the most common limiting effects — stand up slowly and stay hydrated. Slapeloosheid is best managed by taking the last dose early in the day.

Waarschuwingen en voorzorgsmaatregelen

• Tyramine crisis. Strict dietary compliance is essential (see the diet box above), throughout treatment and for 14 days afterwards
• Serotonin syndrome. Do not combine with SSRIs, SNRIs, tricyclics, triptans, tramadol, pethidine, dextromethorphan, St John’s Wort, or linezolid. Observe washout periods in both directions
• Blood pressure. Both high (tyramine reaction) and low (orthostatic) blood pressure are possible — monitor regularly
• Suicidal thoughts. Like all antidepressants, carries a warning for suicidal ideation in those under 25; monitor closely early in treatment and after dose changes
• Surgery / anaesthesia. Tell any surgeon, dentist, or anaesthetist that you take an MAOI well in advance
• Pregnancy / breastfeeding. Use only if the benefit clearly outweighs the risk and under specialist advice
• Alcohol. Avoid — some alcoholic drinks are also high in tyramine

Contraindications — Who Should NOT Take Trivon

• Feochromocytoom (catecholamine-secreting tumour)
• Cerebrovascular disease, established cardiovascular disease, or uncontrolled hypertension
• Concurrent use of other antidepressants, opioids (especially pethidine), or sympathomimetics
• Ernstige leverfunctiestoornis
• Within the required washout window of another serotonergic drug (e.g. 5 weeks after fluoxetine)
• Known hypersensitivity to tranylcypromine

Geneesmiddelinteracties

Always share a full list of prescription medicines, over-the-counter products, herbal supplements, and recreational drugs with your prescriber before starting Trivon.

Wat te doen bij overdosering

MAOI overdose can be serious and its effects may be delayed up to 12 hours. Symptoms include agitation, severe headache, hypertension or hypotension, rapid heartbeat, hyperthermia, muscle rigidity, and seizures. There is no specific antidote — treatment is supportive in hospital with cardiovascular and temperature monitoring. Seek emergency care immediately if an overdose is suspected, even if the person seems well at first.

Bewaaradvies

• Store below 25 °C in a dry place, away from direct sunlight
• Bewaren in de originele blisterverpakking
• Buiten bereik van kinderen houden
• Niet gebruiken na de vervaldatum die op de verpakking staat vermeld
• Ongebruikte tabletten inleveren bij een apotheek met innameprogramma, indien beschikbaar

Gerelateerde alternatieven op MedsBase

Looking for other antidepressant options?

• Selgin — selegiline, a selective MAO-B inhibitor with a lower dietary-tyramine burden at low doses
• Sertima — sertraline, a first-line SSRI often tried before an MAOI (note the required washout between them)
• Bupron XL — bupropion, an NDRI used for low energy and motivation (contraindicated together with MAOIs)
• Mirtaz — mirtazapine, an atypical antidepressant useful for poor sleep and appetite
• Browse all Mental Health medications →

Veelgestelde vragen

What is Trivon used for?

Trivon (tranylcypromine 10 mg) is an MAOI antidepressant used mainly for behandelingsresistente depressie en atypical depression — cases that have not responded well to SSRIs, SNRIs, or other antidepressants. MAOIs are often reserved for these situations because of their dietary and drug interactions.

How long does Trivon take to work?

An early lift in energy and mood is often noticed within 1–3 weeks, with the full antidepressant effect developing over 4–6 weken. If there is no benefit after an adequate dose and duration, your prescriber may adjust the dose or reconsider treatment.

Why do I have to avoid certain foods on Trivon?

Tranylcypromine blocks the enzyme that breaks down tyramine in food. If you eat high-tyramine foods (aged cheese, cured meats, fermented products, tap beer, yeast extracts), tyramine builds up and can cause a sudden, dangerous rise in blood pressure. A tyramine-restricted diet is essential during treatment and for 14 days after stopping.

What is a tyramine or hypertensive crisis?

It is a sharp spike in blood pressure triggered by tyramine-rich food or certain medicines while taking an MAOI. Warning signs are a sudden severe (often throbbing) headache, neck stiffness, palpitations, sweating, nausea, or chest pain. It is a medical emergency — seek urgent care immediately.

Can I take Trivon with other antidepressants?

Nee. Combining an MAOI with SSRIs, SNRIs, tricyclics, or other serotonergic drugs can cause serotonin syndrome. A washout period is required — usually 14 dagen after stopping the MAOI, and 5 weeks after stopping fluoxetine before starting it. Your prescriber will plan any switch.

Can I take cold or flu medicine while on Trivon?

Avoid over-the-counter decongestants and many cough/cold remedies — products containing pseudoephedrine, phenylephrine, ephedrine, or dextromethorphan can cause a hypertensive crisis or serotonin syndrome with an MAOI. Always check with a pharmacist or your prescriber first.

Is Trivon the same as Parnate?

Yes in active ingredient — Trivon contains tranylcypromine sulfate, the same molecule as the brand Parnate^®. It is a generic equivalent at a lower price.

When should I take my dose?

Tranylcypromine is activating, so it is usually taken in the morning and around midday. Taking it in the late afternoon or evening commonly causes insomnia. Follow the schedule your prescriber gives you.

Does Trivon cause weight gain or sexual side effects?

Weight changes and sexual side effects can occur but are generally less pronounced than with many other antidepressants. The most common limiting effects are insomnia and dizziness from low blood pressure on standing.

Can I stop Trivon suddenly?

No — taper gradually under medical supervision to avoid discontinuation effects. Importantly, keep following the tyramine-restricted diet for 14 dagen after your last dose, because the enzyme stays blocked until your body makes new enzyme.

Can I drink alcohol while taking Trivon?

It is best avoided. Beyond the usual effects on mood and sedation, some alcoholic drinks — especially tap/draught beer, certain wines, and unpasteurised products — are high in tyramine and can trigger a hypertensive reaction.

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