Desipramine

Preclpltatloa of symptoms or pbaeothromOtytoma Six days after receiving imipramine. haloperidol and methaqualone. a woman suffered headache and nausea. but she was maintained. for the next 9 years without incident. on perphenazine 2mg + amitriptyline 25mg tid. At the age of 56 years she was switched 10 desipramine 'ano ketoprofen} but after 2 doses of 25mg desipramine she again experienced headache and nausea, and was admitted with signs of agitation. profuse sweating. and cold and moist extremities. with a BP of 90 ISOmm Hg. heart rate \36/min. and RSpirntory rate 20/min. IV saline increased her BP to 1501 120mm Hg. She was found to have severely elevated plasma adrenaline (epinephrine) and noradrenaline (norepinephrine) levels. Symptoms resolved after phenoxybenzamine and propranolol were scaned. and phaeochromocytoma was diagnosed. She is currently back on perphenuine + amitriplyline without adverse effect. The tricyclic antidepressants are noradrenaline reuptake inhibitors and it appears thattnrough thi!. mC£:hanism. oesipramine unmasked a developing phaeochromocytoma. as has been rePQrted before with imipramine. "'chong. M.R. and Kcane. P ~I . Annal,orlmer"al MedIcine Q4 .. '5 ~ l~.r 19K I)

4 ~eaCtLons 3 Apr 198 1 0157,7271/81/0403-0004/0$00.50/0 "C> ADISPress