Interaction between Clonidine and Desipramine in Man

Briant, Robin; Reid, John L.; Dollery, C. T.

doi:10.1136/bmj.1.5852.522

Cited by 132 publications

(26 citation statements)

References 5 publications

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“…It is unlikely, that the cocaine-like properties of the tricyclic antidepressants play a part, since cocaine itself does not diminish the effect of clonidine. The present results are in accordance with die clinical observations by Briant et al (1973), who described that low doses of desipramine may cause a dangerous rise in blood pressure in hypertensive patients who were well controlled by clonidine.…”

Section: Resultssupporting

confidence: 82%

The Reversal of Clonidine-Induced Hypotension by Protriptyline and Desipramine

Zwieten¹

1976

Pharmacology

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The present paper deals with further studies on the interaction between clonidine and tricyclic antidepressants. The pronounced central hypotensive action of 1 μg clonidine/kg, administered into the left vertebral artery of chloralose-anaesthetized cats was readily reversed by protriptyline (300 μg/kg) or desipramine (300 μg/kg), infused via the same route shortly after the development of the maximum hypotensive effect of clonidine. In earlier studies it has been demonstrated that pretreatment with tricyclic antidepressants significantly diminishes the central hypotensive action of clonidine. This interaction has been presumed to occur at the level of central α-adrenoreceptors, where clonidine would be the agonist and tricyclic antidepressants the antagonist. The present findings suggest that a competitive antagonism at the central level, which can occur in either sense, may be involved.

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Section: Resultssupporting

confidence: 82%

The Reversal of Clonidine-Induced Hypotension by Protriptyline and Desipramine

Zwieten¹

1976

Pharmacology

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“…A large variety of tricyclic antidepressants is known to inhibit the central hypo tensive effect of clonidine. This interaction has been established clinically (Briant, et al, 1973) and could be reproduced in animal experiments (van Spanning and van Zwieten, 1973;van Zwieten, 1975avan Zwieten, , 1976. The interaction occurs at the level of central a-adrenoreceptors.…”

mentioning

confidence: 98%

Inhibition of the Central Hypotensive Effect of Clonidine by Trazodone, a Novel Antidepressant

Zwieten¹

1977

Pharmacology

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Trazodone, a non-tricyclic drug with antidepressant properties, diminished the central hypotensive response to clonidine in a dose-dependent manner. Both drugs were infused into the left vertebral artery of chloralose-anaesthetized cats. Intravenously injected trazodone did not reduce the central hypotensive effect of clonidine. The antagonism probably occurs at the level of central α-adrenoreceptors in the brain stem, where clonidine is the α-agonist and trazodone the α-antagonist. Such an antagonism, already known for clonidine and the tricyclic drugs also holds for non-tricyclic antidepressants, provided that they possess α-adrenoreceptor-blocking activity.

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“…This interaction assumes im portance as it is often recommended as a maintenance treatment for bipolar disorder [169], In animals, hypotensive action of cloni dine was reduced drastically by pretreatment with desipramine [170], A clinical report of a patient indicated that the action of clonidine was impaired by the introduction of imipra mine [ 171 ]. Addition of desipramine to cloni dine (Catapres) treatment, in a controlled study, led to loss of blood pressure control in 4 out of 5 hypertensive patients [172], The mechanisms involved in this interaction are the inhibition of intraneuronal uptake of the clonidine and possibly a central effect due to the alpha-adrenergic blocking action of the tricyclic antidepressants. Both MAOIs [173] and tricyclic antidepressants antagonize the effects of guanethidine, bethanidine and clo nidine [172], In a hypertensive patient ade quately treated with guanethidine (75 mg/ day), addition of amitriptyline (25 mg t.i.d.)…”

Section: Antihypertensivesmentioning

confidence: 99%

“…Addition of desipramine to cloni dine (Catapres) treatment, in a controlled study, led to loss of blood pressure control in 4 out of 5 hypertensive patients [172], The mechanisms involved in this interaction are the inhibition of intraneuronal uptake of the clonidine and possibly a central effect due to the alpha-adrenergic blocking action of the tricyclic antidepressants. Both MAOIs [173] and tricyclic antidepressants antagonize the effects of guanethidine, bethanidine and clo nidine [172], In a hypertensive patient ade quately treated with guanethidine (75 mg/ day), addition of amitriptyline (25 mg t.i.d.) required an increase of guanethidine to 300 mg for adequate blood pressure control.…”

Section: Antihypertensivesmentioning

confidence: 99%

Psychotropic and Medical Drug Interactions

Ananth

Johnson

1992

Psychother Psychosom

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In a number of situations, drugs used to treat psychiatric and physical illnesses are coadministered to patients suffering primarily from a psychiatric illness. Hence, coadministration of medical and psychiatric drugs is not uncommon. With increasing use of multiple drugs, our ability to treat a number of disorders has increased, but simultaneously, the problem of drug interactions has also assumed importance. A number of factors contribute to such drug interactions in psychiatric patients. All these interactions are both pharmacologically and genetically determined. Genetic susceptibility is not practical to determine. It is therefore essential for the physician to employ drug combinations only when necessary, be aware of the known clinically significant interactions, anticipate and watch for them, avoid dangerous combinations, and monitor the patients receiving combination of drugs with vigilance.

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Interaction between Clonidine and Desipramine in Man

Cited by 132 publications

References 5 publications

The Reversal of Clonidine-Induced Hypotension by Protriptyline and Desipramine

The Reversal of Clonidine-Induced Hypotension by Protriptyline and Desipramine

Inhibition of the Central Hypotensive Effect of Clonidine by Trazodone, a Novel Antidepressant

Psychotropic and Medical Drug Interactions

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