Phenelzine

Nervous system

A potential risk of using a non-selective inhibitor in patients with Parkinson’s disease is illustrated by separate reports of the appearance of parkinsonism in patients taking phenelzine [ , ].

• Speech blockage, so called, has been reported in a 34-year-old woman who had taken phenelzine 45 mg/day for 2 months [ ]. The adverse effect disappeared on withdrawal and did not recur when her depression was successfully treated with maprotiline 175 mg/day.

Psychiatric

In a carefully controlled 3-week comparison of phenelzine (up to 90 mg/day, mean 77 mg) and imipramine (up to 150 mg/day, mean 139 mg), four patients developed antisocial behavior, three overt paranoid psychosis, and one a hypertensive crisis, despite all precautions to avoid interacting foods and drugs [ ].

There has been a report of delusional parasitosis with phenelzine [ ].

Dose-related visual hallucinations have been reported in a patient with macular degeneration taking phenelzine (the Charles Bonnet syndrome); the authors discussed the possibility that deprivation-induced visual phenomena had been intensified by increased central monoamine concentrations [ ].