Blood pressure crisis following withdrawal of clonidine (Catapres, Catapresan), with special reference to arterial and urinary catecholamine levels, and suggestions for acute management

Hansson, Lennart; Hunyor, Stephen N.; Julius, Stevo; Hoobler, Sibley W.

doi:10.1016/0002-8703(73)90165-8

Cited by 187 publications

(38 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Few studies have investigated the effects of once daily dosage of drugs on blood pressure but if this were possible it would make compliance with a therapeutic regime more likely. Many patients at some stage of their treatment will omit their drugs for one or two days, and the importance of this has been emphasized by the rebound hypertension that may occur when clonidine is ceased (Hansson, 1973).…”

Section: Introduction Methodsmentioning

confidence: 99%

The effect on blood pressure of beta‐adrenoceptor blocking drugs administered once daily and their duration of action when therapy is ceased.

Wilson¹,

Morgan²,

Morgan³

1976

Brit J Clinical Pharma

View full text Add to dashboard Cite

1 The control of blood pressure achieved was similar whether pindolol or propranolol was given once or three times daily. 2 When the drugs were ceased the antihypertensive effect lasted for longer than 24 h. There was no rebound hypertension. 3 The full effect of the drug on blood pressure was seen within 24 h of its recommencement. 4 Changes in blood pressure, pulse rate, and plasma renin activity occurred but these were not considered to be causally related.

show abstract

Section: Introduction Methodsmentioning

confidence: 99%

The effect on blood pressure of beta‐adrenoceptor blocking drugs administered once daily and their duration of action when therapy is ceased.

Wilson¹,

Morgan²,

Morgan³

1976

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…It is now well known that sudden withdrawal of the antihypertensive drug clonidine can give rise to withdrawal phenomena characterized by hyperirritability and rebound hypertension in man (Hansson et al, 1973) and experimental animals (Thoolen et al, 1981;1983). Clonidine dependence of the guinea-pig isolated ileum following incubation for 24 h with clonidine, has also been demonstrated by the presence of a withdrawal contracture on addition of ax-adrenoceptor blocking drugs (Collier et al, 1981).…”

Section: Introductionmentioning

confidence: 99%

The properties of the clonidine withdrawal response of guinea‐pig isolated ileum

Chahl

1985

British J Pharmacology

View full text Add to dashboard Cite

1The dependence-inducing effects of clonidine were investigated on the guinea-pig isolated ileum. Clonidine produced relaxation of the ileum with a threshold concentration between 0.01 and 0.1 imol I-'. Washout of clonidine did not induce a withdrawal contraction. 6 Since clonidine dependence may be induced as rapidly as opiate dependence in the ileum and the pharmacology of the withdrawal responses is similar, it is suggested that they both induce the same post-receptor neuronal feedback disturbance in which substance P neurones play a major role.

show abstract

“…Amphetamines, caffeine, 38 cocaine, 39 phencyclidine, LSD, anorectics containing phenylpropranolamine (e.g., Dexatrim, Anorexin), 40 self-administration of pressor agents (e.g., isoproteronol), 41 pressor agents added to food with criminal intent 42 Known drug effects. Interaction of monoamine oxidase inhibitors and certain foods (e.g , cheese, wine), 43 clonidine withdrawal syndrome, 9 hypertension induced by nasal decongestant 44 or prolonged skin application of steroid-containing ointments 43 or atropine administration 46 3. Hypertensive response to any stressful intervention or acute disease.…”

mentioning

confidence: 99%

Pseudopheochromocytoma.

Kuchel¹

1985

Hypertension

View full text Add to dashboard Cite

A 52-year-old man was admitted to the Brigham and Women's Hospital (BWH) on August 21, 1984, for evaluation of a possible pheochromocytoma. He was first told of his hypertension at age 43 and was treated with /3-blockers, most recently nadolol (40 mg p.o q.d.) with "good control." On August 12, 1984, he was awakened from sleep with spasmotic midepigastnc pain, strong pulsations in his head, a feeling of generalized warmth, nausea, and diaphoresis. He induced vomiting, which did not improve his symptoms, and had an episode of watery diarrhea. He then went to a local hospital, where a blood pressure (BP) of 152/130 mm Hg was noted. He was treated for abdominal pain with 15 mg of morphine sulfate and 10 mg of prochlorperazine maleate (Compazine). Nadolol (40 mg daily) was continued. Results of an upper gastrointestinal series and a sulfobromophthalein function test were normal, and an abdominal ultrasono- He was transferred to BWH on August 21, 1984 He denied any history of palpitations, chest discomfort, or weight loss. On further questioning, the patient stated that he had had a premonition before each episode occurred. Past medical history included the passage of a kidney stone in 1981. Family history included a father and four siblings with onset of high BP in their midthirties. The patient was experiencing stress because of an ongoing divorce and his work as an executive in a computer company. He smoked no cigarettes, drank alcohol socially, and used no other medications On admission, the following BP measurements were recorded: supine, right arm, 190/110 mm Hg, left arm, 170/110 mm Hg, pulse, 60 beats/min; standing, 96/50 mm Hg, pulse, 100 beats/min. Fundi showed artenolar narrowing; lungs were normal. The carotid arteries were without bruits, and examination of the heart revealed no murmur or gallop. Results of an abdominal examination were normal. The ECG was normal. Results of laboratory studies (Tables 1 and 2) were normal except for serum glutamic-oxaloacetic transaminase levels of 128 U/L, serum glutamic-pyruvic transaminase levels of 216 U/L, and alkaline phosphatase levels of 148 U/L. While at the BWH, the patient had no further episodes.

show abstract

Blood pressure crisis following withdrawal of clonidine (Catapres, Catapresan), with special reference to arterial and urinary catecholamine levels, and suggestions for acute management

Cited by 187 publications

References 12 publications

The effect on blood pressure of beta‐adrenoceptor blocking drugs administered once daily and their duration of action when therapy is ceased.

The effect on blood pressure of beta‐adrenoceptor blocking drugs administered once daily and their duration of action when therapy is ceased.

The properties of the clonidine withdrawal response of guinea‐pig isolated ileum

Pseudopheochromocytoma.

Contact Info

Product

Resources

About