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September 21, 1970

Acute Psychosis With Amitriptyline and Furazolidone

Author Affiliations

Gainsville, Fla

JAMA. 1970;213(12):2080. doi:10.1001/jama.1970.03170380054017

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To the Editor.—  Serious adverse reactions, including death, have been reported following the combined use of a drug with monoamine-oxidase-inhibiting properties and a number of drugs or foods, including the tricyclic antidepressants such as imipramine hydrochloride and amitriptyline hydrochloride.Furazolidone is a synthetic antimicrobial nitrofuran used for specific and symptomatic treatment of bacterial or protozoal diarrhea and enteritis. Inhibition of monoamine oxidase by furazolidone has been demonstrated. In the following case, a toxic psychosis resulted when furazolidone was taken by a person already taking amitriptyline.

Report of a Case.—  A 49-year-old woman with symptoms of depression was treated with amitriptyline hydrochloride, 75 mg daily, beginning April 22, 1970. Her depression improved rapidly and the amitriptyline was continued at the same dosage. She also continued to take estrogenic substances conjugated, 1.25 mg daily, which she had taken since a hysterectomy and oophorectomy in 1958.On May 22 a physician prescribed furazolidone