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  • Title: Urinary amine metabolite excretion in a patient with adrenergic hyperactivity state: reaction to phenelzine withdrawal and combined treatment.
    Author: Modai I, Beigel Y, Cygielman G.
    Journal: J Clin Psychiatry; 1986 Feb; 47(2):92-3. PubMed ID: 2418010.
    Abstract:
    Urinary MHPG (3-methoxy-4-hydroxyphenylglycol) amounts increased threefold during a toxic delirious state in a 57-year-old bipolar patient 3 days after phenelzine treatment was stopped. This norepinephrine metabolite was not expected to rise as monoamine oxidase (MAO) was completely blocked. In addition, the delirious state appeared as a rebound phenomenon and not an acute toxic state during drug administration. It seems that phenelzine acts more through catecholamine release phenomenon than by inhibition of MAO.
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