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Acute myocarditis after massive phenelzine overdose.

W Stephen Waring¹, William A H Wallace

¹Scottish Poisons Information Bureau, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK. s.waring@ed.ac.uk

European Journal of Clinical Pharmacology

|September 8, 2007

Summary

Monoamine oxidase inhibitors (MAOIs) overdose can cause severe cardiac issues. A case study revealed phenelzine toxicity led to acute myocarditis and hypotension in a young adult.

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Area of Science:

Pharmacology
Cardiology
Toxicology

Background:

Monoamine oxidase inhibitors (MAOIs) are rarely used due to adverse effects.
Renewed interest exists in MAOIs for psychiatric disorders.
Clinical features of MAOI overdose are not well-characterized.

Observation:

A young adult experienced a massive phenelzine overdose.
The patient presented with reduced consciousness, seizures, and tachycardia.
Unexpectedly, severe hypotension and impaired left ventricular function developed.

Findings:

High serum phenelzine concentrations were confirmed post-mortem.
Histopathology revealed drug-induced acute myocarditis.
The patient died 3 days after presentation.

Implications:

Acute myocarditis is a potential complication of phenelzine toxicity.
This complication should be considered in patients with unexplained hypotension after phenelzine overdose.
Further research into MAOI cardiotoxicity is warranted.