Two fatal cases of hyperpyrexia and coma (
symptoms similar to serotonin 
syndrome) have occurred in patients taking phenelzine with 
dextromethorphan (in overdosage in one case). Three other serious but non-fatal reactions occurred in patients taking 
dextromethorphan with 
isocarboxazid or phenelzine.  
MAOIs are contraindicated with 
dextromethorphan.