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TCA to MAOI when switching from a TCA to a MAOI, general advice is to allow at least a seven day washout period before starting treatment with low-dose MAOI however, the SmPC for phenelzine tablets advises a 14 day washout period after stopping a TCA - should be extended to 21 days if the TCA is clomipramine or imipramine as these are more potent inhibitors of serotonin reuptake and the risk of serotonin syndrome will consequently be increased BNF suggests a seven to 14 day washout period, extended to 21 days if clomipramine or imipramine have been taken switches involving tranylcypromine, phenelzine, clomipramine or imipramine, are at greater risk of adverse reactions due to their potent effects on serotonin reuptake switching between any of these agents should be done with extreme caution c

L Lysine injections are elective wellness services and are not intended to diagnose or treat medical conditions

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