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Acute psychosis following phenelzine discontinuation
Abstract:
Most concern over the untoward effects of monoamine oxidase inhibitors (MAOIs) has concentrated on the hypertensive crises and recently on orthostatic hypotension, hypomania, and sexual dysfunction. However, little has been written about withdrawal effects when MAOIs are discontinued. This article reports an acute organic psychosis marked by visual, auditory, and tactile hallucinations after abrupt discontinuation of phenelzine in two young women without previous history of psychotic symptoms.
Insights
Abruptly stopping phenelzine, a monoamine oxidase inhibitor (MAOI), can cause acute organic psychosis. This includes hallucinations in patients with no prior history of psychotic symptoms.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Monoamine oxidase inhibitors (MAOIs) are primarily known for adverse effects like hypertensive crises and orthostatic hypotension.
- Limited research exists on the withdrawal symptoms associated with discontinuing MAOIs.
Observation:
- Two young women experienced acute organic psychosis following the abrupt cessation of phenelzine treatment.
- Neither patient had a prior history of psychotic disorders.
Findings:
- The psychosis manifested with prominent visual, auditory, and tactile hallucinations.
- This suggests a potential link between abrupt MAOI discontinuation and the onset of psychotic symptoms.
Implications:
- Clinicians should be aware of the potential for severe psychiatric withdrawal syndromes, including psychosis, after MAOI discontinuation.
- Further research is warranted to understand the neurobiological mechanisms and clinical management of MAOI withdrawal-induced psychosis.