Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-26T14:03:24.133Z Has data issue: false hasContentIssue false

Pseudophaeochromocytoma associated with clozapine treatment

Published online by Cambridge University Press:  13 June 2014

Sarah E Prasad
Affiliation:
Central Mental Hospital, Dundrum, Dublin 14, Ireland
Harry G Kennedy
Affiliation:
Central Mental Hospital, Dundrum, Dublin 14 and Academic Department of Psychiatry, Trinity College Dublin, Ireland

Abstract

We describe a 44 year old man with treatment resistant schizophrenia who developed pseudophaeochromocytoma on clozapine with high blood pressure, tachycardia and elevated 24 hour urinary catecholamines. All resolved on discontinuing clozapine. We reviewed the literature and found five other cases. We suggest that this is a common side effect, transient in some patients. Elevated plasma noradrenaline does not appear to be relevant to the unique benefits of clozapine.

Type
Case Reports
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kane, J, Honigfeid, G, Singer, J, Meltzer. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45: 789796CrossRefGoogle ScholarPubMed
2. Maudsley prescribing guidelines, 2001Google Scholar
3.Breier, A. Clozapine and Noradrengic function: Support for a novel hypothesis for superior efficacy. J Clin Psychiatry 1994; 55: 122125Google ScholarPubMed
4.Shiwach, RS. Treatment of clozapine induced hypertension and possible mechanisms. Clin Neuropharmacology 1998; 21: 139140Google ScholarPubMed
5.Walther, MM, Keiser, HR, Linehan, WM. Pheochromocytoma: evaluation, diagnosis and treatment. World J Urology 1999; Feb; 17(1): 35–9CrossRefGoogle ScholarPubMed
6.George, TP, Winter, LC. Hypertension after initiation of clozapine. Am J Psychiatry 1996; 153: 13681369Google ScholarPubMed
7.Gupta, S. Paradoxical hypertension associated with clozapine. Am J Psychiatry 1994; 151: 148Google ScholarPubMed
8.Krentz, AJ, Mikhail, S, Cantrell, P, Hill, GM, Pseudophaeochromocytoma syndrome associated with clozapine. BMJ 2001; 322: 1213CrossRefGoogle ScholarPubMed
9.Li, JKY, Yeung, VTF, Leung, CMet al.Clozapine a mimicry of phaeochromocytoma. Aust N2 J Psychiatry 1997;31:889–91CrossRefGoogle ScholarPubMed
10.Mayer, RD, Montgomery, SA. Acute hypertensive episode induced by sulpiride-a case report. Human Psychopharmacology 1989; 4: 149–50CrossRefGoogle Scholar
11.Breier, A, Buchanan, RW, Waltrip, RWet al.The effect of clozapine on plasma norepinephrine: relationship to clinical efficacy. 1994; 10:17Google ScholarPubMed
12.Elman, I, Goldstein, DS, Eisenhofer, Get al.Mechanism of peripheral noradrenergic stimulation by clozapine. Neuropsychopharmacology 1999; 20: 2934CrossRefGoogle ScholarPubMed