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Withdrawal Syndromes and the Cessation of Antihypertensive Therapy

Withdrawal Syndromes and the Cessation of Antihypertensive Therapy Abstract To the Editor. —In the August Archives (1981;141:1125-1127), Hart and Anderson excellently reviewed the withdrawal syndromes after cessation of antihypertensive therapy. Concerning the interaction of clonidine hydrochloride and β-blockers, we would like to make the following comments based on our clinical studies.1The deleterious effect of propranolol hydrochloride on the clonidine withdrawal reaction has been well verified.2,3 This might result from the blockade of β-receptor-mediated vasodilation, and, if so, β1-selective blockers should be beneficial. In a pilot study of four hypertensive patients, the previous administration of clonidine hydrochloride, 0.3 mg three times a day, was abruptly changed to atenolol, 50 mg twice a day, while diuretic therapy continued.1 All these patients had disturbing subjective symptoms of restlessness, sweating, headache, and insomnia within 24 to 36 hours after the last dose of clonidine. The Figure shows the substantial rises in the mean values of systolic and References 1. Lilja M, Jounela AJ, Juustila H, et al: Abrupt and gradual change from clonidine to beta blockers. Acta Med Scand , to be published. 2. Bailey RR, Neale TJ: Rapid clonidine withdrawal with blood pressure overshoot exaggerated by beta-blockade. Br Med J 1976;1:942-943.Crossref 3. Harris AL: Clonidine withdrawal and blockade. Lancet 1976;1:596.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Withdrawal Syndromes and the Cessation of Antihypertensive Therapy

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340170199034
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —In the August Archives (1981;141:1125-1127), Hart and Anderson excellently reviewed the withdrawal syndromes after cessation of antihypertensive therapy. Concerning the interaction of clonidine hydrochloride and β-blockers, we would like to make the following comments based on our clinical studies.1The deleterious effect of propranolol hydrochloride on the clonidine withdrawal reaction has been well verified.2,3 This might result from the blockade of β-receptor-mediated vasodilation, and, if so, β1-selective blockers should be beneficial. In a pilot study of four hypertensive patients, the previous administration of clonidine hydrochloride, 0.3 mg three times a day, was abruptly changed to atenolol, 50 mg twice a day, while diuretic therapy continued.1 All these patients had disturbing subjective symptoms of restlessness, sweating, headache, and insomnia within 24 to 36 hours after the last dose of clonidine. The Figure shows the substantial rises in the mean values of systolic and References 1. Lilja M, Jounela AJ, Juustila H, et al: Abrupt and gradual change from clonidine to beta blockers. Acta Med Scand , to be published. 2. Bailey RR, Neale TJ: Rapid clonidine withdrawal with blood pressure overshoot exaggerated by beta-blockade. Br Med J 1976;1:942-943.Crossref 3. Harris AL: Clonidine withdrawal and blockade. Lancet 1976;1:596.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1982

References