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Br Heart J. 1985 June; 53(6): 654–658.
PMCID: PMC481831

Ventricular tachycardia induced by clonidine withdrawal.


Ventricular tachycardia developed after the abrupt withdrawal of clonidine in a patient with atrial septal defect of the ostium secundum type, renal insufficiency, and hypertension. Ventricular tachycardia was completely suppressed by intravenous phentolamine, which contrasted with the limited effectiveness of intravenous lignocaine and procainamide. Sublingual glyceryl trinitrate or inhaled amyl nitrate reduced the blood pressure to a level similar to that after phentolamine but had no effect on the ventricular tachycardia. Ventricular tachycardia was probably produced by humoral or neural stimulation, or both, of upregulated myocardial alpha adrenoceptors.

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Selected References

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  • Goldberg AD, Wilkinson PR, Raftery EB. The over-shoot phenomenon on withdrawal of clonidine therapy. Postgrad Med J. 1976;52 (Suppl 7):128–136. [PubMed]
  • O'Connor DE. Accelerated acute clonidine withdrawal syndrome during coronary artery bypass surgery. A case report. Br J Anaesth. 1981 Apr;53(4):431–433. [PubMed]
  • Houston MC. Clonidine hydrochloride: review of pharmacologic and clinical aspects. Prog Cardiovasc Dis. 1981 Mar-Apr;23(5):337–350. [PubMed]
  • Whitsett TL. Abrupt cessation of treatment with centrally acting antihypertensive agents. A review. Chest. 1983 Feb;83(2 Suppl):400–402. [PubMed]
  • Corr PB, Crafford WA., Jr Enhanced alpha-adrenergic responsiveness in ischemic myocardium: role of alpha-adrenergic blockade. Am Heart J. 1981 Sep;102(3 Pt 2):605–612. [PubMed]
  • DiMicco JA, Prestel T, Pearle DL, Gillis RA. Mechanism of cardiovascular changes produced in cats by activation of the central nervous system with picrotoxin. Circ Res. 1977 Oct;41(4):446–451. [PubMed]
  • Isaac L. Clonidine in the central nervous system: site and mechanism of hypotensive action. J Cardiovasc Pharmacol. 1980;2 (Suppl 1):S5–19. [PubMed]
  • Yamada S, Yamamura HI, Roeske WR. An increase in cardiac alpha 1-adrenoceptors following chronic clonidine treatment. Naunyn Schmiedebergs Arch Pharmacol. 1982 Aug;320(2):115–118. [PubMed]

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