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Pseudo‐phaeochromocytoma after multiple drug interactions involving the selective monoamine oxidase inhibitor selegiline
Author(s) -
Lefebvre H.,
Noblet C.,
Moore N.,
Wolf L. M.
Publication year - 1995
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1995.tb02604.x
Subject(s) - selegiline , tyramine , monoamine oxidase , antidepressant , tricyclic , monoamine oxidase b , pharmacology , tricyclic antidepressant , monoamine oxidase inhibitor , ephedrine , endocrinology , medicine , monoamine oxidase a , chemistry , drug , enzyme , biochemistry , hippocampus , disease , parkinson's disease
Summary A patient presented with paroxysmal hypertension and typical clinical features of phaeochromocytoma, but with a normal adrenal computed tomographic scan and much higher plasma noradrenaline than adrenaline concentrations. Urinary vanillyimandelic acid concentrations were only moderately elevated. This syndrome probably arose as a consequence of an interaction between the monoamine oxidase inhibitor selegiline, the sympathomimetic agent ephedrine, and a tricyclic antidepressant The mechanism of the interaction is thought to be related to increased sympathetic release of noradrenaline by ephedrine, inhibition of catabolism by selegiline, and inhibition of reuptake of noradrenaline by the tricyclic. Although newer selective monoamine oxidase inhibitors are considered to be safer than earlier non‐selective inhibitors, they can also contribute to drug intersections mimicking phaeochromocytoma.