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Clinical Notes
March 21, 1964

Tranylcypromine Sulfate TherapyOccurrence of Severe Paroxysmal Headache

JAMA. 1964;187(12):957-958. doi:10.1001/jama.1964.03060250075023

TRANYLCYPROMINE (Parnate) sulfate, a non-hydrazine monoamine oxidase inhibitor (trans, d,1-2-phenylcyclopropylamine sulfate), is used in the treatment of mental depression. The following adverse reactions have been reported to result from treatment with this drug: restlessness, insomnia, dizziness, headache, anorexia, nausea, epigastric distress, diarrhea, constipation, dermatitis, palpitations, hypertension, photophobia, leg cramps, tachycardia, edema, and hypotension, the latter occurring predominantly in hypertensive patients. Paroxysmal hypertension and severe headache have sometimes been associated with intracranial hemorrhage and death. Such reactions are characterized by a severe occipital headache which may radiate frontally, palpitation, stiffness of the neck, nausea, vomiting, sweating (sometimes with fever or cold, clammy skin), and photophobia. Either tachycardia or bradycardia may occur, and constricting chest pain and dilated pupils have been noted.1,2

The following case prompted us to review the adverse effects of tranylcypromine.

Report of a Case  A 33-year-old white male engineer registered at the Cleveland Clinic on June 6,

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