Council on Drugs

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Abstract
Paradoxical Hypertension From Tranylcypromine Sulfate Recently EVIDENCE has accumulated to show that tranylcypromine sulfate (Parnate Sulfate), an antidepressant drug of the monoamine oxidase inhibitor-type, has produced intracranial bleeding, sometimes resulting in death, in patients who had exhibited paradoxical hypertension and severe headache.1-3 The latter two reactions of tranylcypromine, as well as other adverse effects associated with this group, have previously been described by the Council on Drugs.4 However, unlike the other monoamine oxidase inhibitors that are currently used as antidepressants, tranylcypromine is not a derivative of hydrazine, but is structurally related to amphetamine. Whether this similarity in chemical structure is related to the new reaction is an interesting subject for speculation, since hypertension is not a characteristic effect of the monoamine oxidase inhibitors, but may be an occasional response to the amphetamines, which have a sympathomimetic effect. Those adverse effects that have been previously reported for tranylcypromine

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