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Hypertensive urgency induced by an
interaction of mirtazapine and clonidine.
Abo-Zena
RA, Bobek MB, Dweik RA.
Department of Pharmacy Practice, The
Cleveland Clinic Foundation, Ohio, USA.
Mirtazapine is a new
antidepressant with a tetracyclic chemical structure that is not related
to selective serotonin reuptake inhibitors, tricyclic antidepressants,
or monoamine oxidase inhibitors. The antidepressant effect results from
stimulation of the noradrenergic system through antagonism at central
(alpha2-inhibitory receptors. Clonidine exerts its antihypertensive
effect by stimulating these receptors to cause a reduction in endogenous
release of norepinephrine. Therefore, the two agents have mechanisms of
action that potentially oppose one another. We report a case of
hypertensive urgency that ensued after a patient stabilized on clonidine
began taking mirtazapine.
Publication Types:
PMID: 10772378 [PubMed - indexed for
MEDLINE]
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