Delirium, thrombocytopenia, insomnia, and mild liver damage associated with MAOI withdrawal

摘要

Monoamine oxidase inhibitors (MAOIs) are effective second-line treatment options for depression [1, 2]. A recent study showed that tranylcypromine (TCP), a nonselective and irreversible MAOI, remains commonly used in standard psychiatric clinics [3]. The risk of hypertensive crisis due to drug-food interactions when MAOIs are prescribed is widely known. Less well appreciated is the fact that MAOIs can cause addiction and that a particular patient population may be at high risk. Here we present a case of TCP dependence that brings together all signs and symptoms so far described after TCP withdrawal, including delirium, thrombocytopenia, insomnia, and mild liver damage.