Nocturnal Orthostatic Syncope in Pargyline Therapy

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Abstract
AS NEWER and more potent hypotensive agents become available we may expect to see iatrogenic orthostatic hypotension more frequently. This is particularly true with potent monoamine oxidase inhibitors. This side effect causes serious disability in the recipients. The following brief case reports illustrate this side effect in the course of therapy with a new nonhydrazine monoamine oxidase inhibitor, pargyline hydrochloride. Report of Cases Case 1.— A 57-year-old white normotensive female with involutional depression, insomnia, and crying spells was placed on 25 mg of pargyline hydrochloride daily as part of a clinical evaluation of its effectiveness in depression. After two weeks of therapy the patient noted some slight improvement in her mood, but during the night had to get up to urinate. She walked to the bathroom, where, with no subjective warning, she fell to the floor, striking the side of her head. She does not remember if she lost consciousness.

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