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Hypertensive Urgency Induced by an Interaction of Mirtazapine and Clonidine
Author(s) -
AboZena Reem A.,
Bobek Mary Beth,
Dweik Raed A.
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.5.476.35061
Subject(s) - mirtazapine , clonidine , antidepressant , pharmacology , tricyclic , mianserin , monoamine oxidase , serotonin , stimulation , norepinephrine , reuptake , reuptake inhibitor , medicine , chemistry , receptor , dopamine , biochemistry , hippocampus , enzyme
Mirtazapine is a new antidepressant with a tetracyclic chemical structure that is not related to selective serotonin reuptake inhibitors, tricyclic antidepressants, or monoamine oxidase inhibitors. The antidepressant effect results from stimulation of the noradrenergic system through antagonism at central a2‐inhibitory receptors. Clonidine exerts its antihypertensive effect by stimulating these receptors to cause a reduction in endogenous release of norepinephrine. Therefore, the two agents have mechanisms of action that potentially oppose one another. We report a case of hypertensive urgency that ensued after a patient stabilized on clonidine began taking mirtazapine.