The neuroprotective aspect is pretty cool. I admittedly don't know much about that and should look into it more. I don't know how selective it is for the B isoform of MAO. I suspect it is not hugely clinically significant as it is typically characterised as unselective. Moclobemide is considered selective for MAO-A but actually inhibits MAO-B by 20-30% from memory so it would stand to reason any MAO-B selectivity in the case of Tranylcypromine is significantly less than this, considering how it is classified. Just my theory at least, hope it made sense (I had a lot of pregabalin last night). Tranylcypromine is also a dopamine releasing agent, just like amphetamine though less potent (1/10 I believe), in addition to its MAO inhibition.
Delving into the positive aspects for me, I have experienced an markedly increased tolerance for stress with things like work - when things get crazy at my job (phlebotomy) I am totally unfazed. I couldn't believe how strong this effect is as I am usually someone highly negatively affected mentally by stress. There is a noticeable stimulant effect, though mild, but unlike amphetamine or meth (in my opinion), there is a motivational push behind it. On day 2 I started working out and returned to eating vegan, meal prepping everyday. It's really allowing me to just push through life getting done what I need and want to do. It makes me feel as young, energetic and happy as I should for a 24 year old. The constant fatigue, lack of motivation and every other aspect of my depression and anxiety that has weighed me down for the last 10 years and really hindered my ability to move about the world in the way that I want has all lifted. The noticeable part of the stimulant effect, in the sense of a buzz, has gone away so there is some tolerance there I suppose, but I would still say it stimulates me in that I feel like I have a normal energy level that I can't remember having since being in my teens.
The main side effect for me is insomnia, some nights are really hard to fall asleep. I have always struggled with this to an extent though so I don't know how much of it really is the Tranylcypromine. I do get occasional low diastolic blood pressure which can make me feel a bit faint for a few seconds when I stand up, nothing like the severe orthostatic hypotension some speak of. Also I do experience a slight drop in my mood and energy (comparable to a caffeine crash in severity) in the afternoon if I take it all in the morning without a midday dose. I suspect this is due to the dopamine releasing effect wearing off throughout the day. All in all, side effects are pretty minimal and can be attenuated. The diet is also not as hard as it seems just looking at it. I still eat soy sauce, vegemite, protein powder, tempeh, miso soup, kimchi, sauerkraut, fake meats, all the beans and nuts I want, drink wine and kefir. Nothing has spiked my blood pressure. That being said everyone taking Tranylcypromine should exercise the caution with these foods as professionally advised. Everyone's tyramine sensitivity is different so people should experiment with tiny amounts first and monitor their blood pressure for the next 2 hours to see if there is a rise.
All in all, it's been great for me. It's the only antidepressant that has really attenuated my symptoms to the degree that I can focus on real life self improvement. The demonisation of the drug is unwarranted in my opinion. It's really not as dangerous or difficult to use as people make it out to be. Sure, I can't take MDMA or other stimulants anymore, but that is probably for the better. I can still at least use LSD and nitrous which are and always have been my main substances of choice. I experience severe worrying headaches when I smoke any amount of any cannabis now (and did while on high dose Moclobemide too). They are not officially contraindicated substances and I don't get a blood pressure rise from doing so, so I'm not sure I'm in any real danger when I get stoned, but the pain and anxiety (it's sent me to ER 3 times) it triggers are not worth the high for me anymore. As far as I know this is pretty unique and I've never heard of people having trouble with cannabis and MAOIs before so don't be scared off if you are thinking about MAOI therapy people! I would recommend it to anyone with depression and anxiety that has found little relief on the usual medication merrygo-round of SSRIs, SNRIs, NRIs, TCAs, TeCAs, SARIs, SMSs and so on, especially if they have significant lethargic and amotivational features.
If you have any more questions or anything you'd like me to expand on just ask
