MAOIs are dangerous in overdose, and suicidal patients may exploit the inherent toxicity to commit suicide (268). A fatal dose is considered to be 4-6 mg/kg body weight (69). The onset of symptoms usually occurs 6-12 h after ingestion of a toxic dose, but has been known to be delayed by 24 h. Clinical presentation of a patient who overdosed with an MAOI may include fainting, anxiety, flushing and sweating, headachy, tachycardia, and tremor in early stages; this will progress to agitation, coma, seizures, severe hypotension, and possible cardiac arrest (69). Also, physical tolerance and dependence has been reported with tranylcypromine, with one patient taking doses as high as 440 mg daily (269).
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