THE ADVISABILITY of avoiding a combination of imipramine hydrochloride and monoamine oxidase inhibitors is fairly well established. However, as the seriousness of these reactions, even when the drugs are not taken simultaneously, is not widely recognized, the following case is reported. Report of a Case A 41-year-old female was admitted to Rancocas Valley Hospital on March 6, 1963, at 8:30 PM. For the preceding three weeks tranylcypromine sulfate, 10 mg, twice daily had been prescribed by her family physician (A.W.). Since she failed to respond, she was referred for psychiatric evaluation (S.W.) and the suspicion of depression confirmed. On the day of admission she had become increasingly restless. At 7 PM she complained of excruciating headache. Her husband was advised to take her to the hospital but en route she lost consciousness and started to convulse. At 9 PM she was deeply comatose and did not respond to any stimuli