Effect of yohimbine on blood pressure in patients with depression and orthostatic hypotension induced by clomipramine

Orthostatic hypotension, one of tricyclic antidepressant treatment's side effects, is also a factor in limiting adequate antidepressant dosing. We tested in a double‐blind, crossover, placebo‐controlled study the effect of low doses (4 mg/t.i.d.) of yohimbine in 12 patients with depression with ciomipramine‐induced orthostatic hypotension. Yohimbine, a selective α 2 ‐adrenoceptor antagonist, had a favorable effect in orthostatic hypotension and induced a significant increase in blood pressure. A pharmacodynamic and pharmacokinetic interaction between yohimbine and clomipramine or demethylclomipramine was discussed. Clinical Pharmacology and Therapeutics (1989) 45, 241–251; doi: 10.1038/clpt.1989.24