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Related Experiment Video

Updated: Jul 6, 2026

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

Withdrawal from high-dose tranylcypromine.

F Eyer¹, E Jetzinger, R Pfab

¹Department of Toxicology, Klinikum rechts der Isar, München, Germany.

Clinical Toxicology (Philadelphia, Pa.)

|March 18, 2008

Summary

Physostigmine effectively treated tranylcypromine-induced delirium and thrombocytopenia in a substance abuse patient. This reversal highlights physostigmine

Area of Science:

Neuroscience
Pharmacology

Background:

Tranylcypromine, a monoamine oxidase inhibitor, has abuse potential.
Abrupt cessation can lead to withdrawal symptoms.

Observation:

A 34-year-old man developed thrombocytopenia and delirium after high-dose tranylcypromine cessation.
Delirium was unresponsive to conventional treatments like haloperidol and diazepam.

Findings:

Intravenous physostigmine administration rapidly, though temporarily, resolved the delirium.
Continuous physostigmine infusion led to sustained delirium resolution without cholinergic side effects.
Thrombocytopenia resolved spontaneously.

Implications:

Physostigmine is a potential antidote for tranylcypromine-induced delirium.

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This case underscores the importance of considering specific drug toxicities in complex withdrawal syndromes.

Further research into MAOI-induced neurological complications and their management is warranted.