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Cardiac arrhythmias after abrupt clonidine withdrawal
Author(s) -
Peters Robert W,
Hamilton Bruce P,
Hamilton Jennifer,
Kuzbida Gregory,
Pavlis Richard
Publication year - 1983
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1983.194
Subject(s) - palpitations , clonidine , medicine , blood pressure , heart rate , anesthesia , ventricular tachycardia , tachycardia , cardiology , vomiting , nausea
Abrupt clonidine withdrawal may be associated with sharp marked increases in catecholamine levels, heart rate, and blood pressure, which may induce nausea, vomiting, and palpitations. Relatively little information is available on the incidence of cardiac arrhythmias in this setting. With continuous ambulatory ECG recordings, we determined the incidence of arrhythmias in seven male hypertensive patients (without active heart disease) after abrupt clonidine withdrawal. Serious ventricular arrhythmias, including brief ventricular tachycardia, developed in two patients who had greater increases in mean systolic blood pressure (28 ± 3 vs 10 ± 8 mm Hg) and double product (552 ± 681 vs 333 ± 195) than the others. The differences were not significant. Ventricular arrhythmias were not related to age, dose, withdrawal symptoms, initial blood pressure, urinary norepinephrine levels, or ECG abnormalities. We conclude that serious ventricular arrhythmias may be relatively common but unpredictable during clonidine withdrawal, even in patients with no clinically apparent heart disease. The triggering of ventricular arrhythmias should be added to the list of components of clonidine withdrawal syndrome. Clinical Pharmacology and Therapeutics (1983) 34, 435–439; doi: 10.1038/clpt.1983.194