Withdrawal syndrome following cessation of antihypertensive drug therapy

International Journal of Clinical Practice

Volumn 59, Issue 5, 2005, Pages 562-570

  Karachalios, G N ^a   Charalabopoulos, A ^b   Papalimneou, V ^b,c   Kiortsis, D ^b   Dimicco, P ^d   Kostoula, O K ^b   Charalabopoulos, K ^b,e  

^a RED CROSS HOSPITAL   (Greece)

^b UNIVERSITY OF IOANNINA   (Greece)

^c KAT HOSPITAL   (Greece)

^d SECOND UNIVERSITY OF NAPLES   (Italy)

^e NONE   (Greece)

Author keywords

Antihypertensive drugs; Hypertension; Withdrawal syndrome

Indexed keywords

ALPHA ADRENERGIC RECEPTOR BLOCKING AGENT; ANTIHYPERTENSIVE AGENT; ATENOLOL; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BETANIDINE; CALCIUM ANTAGONIST; CLONIDINE; DIAZOXIDE; DILTIAZEM; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; GANGLION BLOCKING AGENT; GUANABENZ; GUANETHIDINE; HYDRALAZINE; METHYLDOPA; METOPROLOL; MINOXIDIL; NITROPRUSSIDE SODIUM; OXPRENOLOL; PHENTOLAMINE MESYLATE; PINDOLOL DERIVATIVE; PRACTOLOL; PROPRANOLOL; RESERPINE; SARALASIN; THIAZIDE DIURETIC AGENT; TIMOLOL; UNINDEXED DRUG; VASODILATOR AGENT; VERAPAMIL;

AGITATION; ANXIETY; BRADYCARDIA; CLINICAL TRIAL; CONSTIPATION; DIAPHORESIS; DROWSINESS; DRUG DOSE REGIMEN; DRUG HALF LIFE; DRUG MECHANISM; DRUG WITHDRAWAL; FATIGUE; FLUSHING; HEADACHE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HEART PALPITATION; HICCUP; HUMAN; HYPERTENSION; HYPERTHYROIDISM; HYPOTENSION; INSOMNIA; LUNG EDEMA; MALAISE; MYALGIA; NAUSEA; NERVOUSNESS; PATHOGENESIS; PRIORITY JOURNAL; RESTLESSNESS; REVIEW; SALIVATION; SIDE EFFECT; STOMACH PAIN; SWEATING; TACHYCARDIA; TREMOR; VOMITING; WITHDRAWAL SYNDROME; XEROSTOMIA; ADRENERGIC SYSTEM; CHEMICALLY INDUCED DISORDER; DRUG COMBINATION; PATHOPHYSIOLOGY;

ANTIHYPERTENSIVE AGENTS; DRUG THERAPY, COMBINATION; HUMANS; HYPERTENSION; SUBSTANCE WITHDRAWAL SYNDROME; SYMPATHETIC NERVOUS SYSTEM;

EID: 27144493011     PISSN: 13685031     EISSN: 17421241     Source Type: Journal    
DOI: 10.1111/j.1368-5031.2005.00520.x     Document Type: Review

References (79)

1. Takata Y, Yoshizumi T, Ito Y et al. Comparison of withdrawing antihypertensive therapy between diuretics and angiotensin converting inhibitors in essential hypertensives. Am Heart J 1992; 124: 1574-80.
2. Hog Y, Blaufox MD, Wassertheil-Smaller S, Oberman A, Langford H. Plasma renin predicts success of antihypertensive drug withdrawal. Am J Hypertens 1994; 7: 679-84.
3. Raftery EB. Cardiovascular drug withdrawal syndromes: a potential problem with calcium antagonists? Drugs 1984; 28: 371-4.
4. Houston MC. Abrupt cessation of treatment in hypertension; considerations of clinical features, mechanisms, prevention and management of the discontinuation syndrome. Am Heart J 1981; 102: 415-30.
5. Jennings GL, Reid C, Sudhir KM, Laufer E, Korner PI. Factors influencing the success of withdrawal of antihypertensive drug therapy. Blood Press 1995; 2 (Suppl): 99-107.
6. Houston M, Hodge R. Beta-adrenergic blocker withdrawal syndromes in hypertension and cardiovascular diseases. Am Heart J 1988; 116: 515-23.
7. Hanson L, Huynor SN. Blood pressure overshoot due to acute clonidine (catapres) withdrawal: studies on arterial and urinary catecholamines and suggestions for management of the crisis. Clin Sci Mol Med 1973; 45 (Suppl. 1): S181-3.
8. Hokfelt B, Hedeland H, Dynling JF. Studies on catecholamines, rennin and aldosterone following catapresan (2-(2,6 dichlorphenylamine)-2-imidazoline hydrochloride) in hypertensive patients. Eur J Pharmacol 1970; 10: 389-97.
9. Huyor SN, Hansson L, Harisson TS, Hoobler SW. Effects of clonidine withdrawal: possible mechanisms and suggestions for management. BMJ 1973; 2: 209-11.
10. Svensson TH, Strombom U. Discontinuation of chronic clonidine treatment: evidence for facilitated brain noradrenergic neurotransmission. Naunyn Schmiedebergs Arch Pharmacol 1977; 299: 83-7.
11. Geykess GG, Boer P, Dorhout Meers EJ. Clonidine withdrawal: mechanism and frequency of rebound hypertension. Br J Clin Pharmacol 1979; 7: 55-62.
12. Liljia M, Jounela AJ, Juustila HJ, Paalzow L. Abrupt and gradual change from clonidine to β-blockers in hypertension. Acta Med Scand 1982; 211: 375-80.
13. Bailey RR, Neale TJ. Rapid clonidine withdrawal with blood pressure overshoot exaggerated by β-blockade. BMJ 1976; 1: 942-3.
14. Brodsky JB, Bravo JJ. Acute postoperative clonidine withdrawal syndrome. Anesthesiology 1976; 44: 519-20.
15. Goldberg D, Wilkinson PR, Raftery EB. The overshoot phenomenon on withdrawal of clonidine therapy. Postgrad Med J 1976; 52 (Suppl. 7): 128-36.
16. Goldberg AD, Raftery EB, Wilkinson PR. Blood pressure and heart rate and withdrawal of antihypertensive drugs. BMJ 1977; 1: 1243-6.
17. Konner JS, Birch R, Frankel HL, Peart WS, Mathias CJ. Hemodynamic and neurohormonal effects of clonidine in patients with preganglionic and postganglionic sympathetic lesions. Evidence for a central sympatholytic action. Circulation 1991; 84: 75-83.
18. Oates HF, Stoker LM, Monggham JC, Stoker GS. Withdrawal clonidine. Effects of varying dosage or duration of treatment on subsequent blood pressure and heart responses. J Pharmacol Exp Ther 1978; 206: 268-73.
19. Hoobler SW, Kashima T. Central nervous system action of clonidine in hypertension. Mayo Clin Proc 1977; 52: 395-8.
20. Reid JL, Dargie HL, Davies DS, Wing LMH, Hamilton CA, Dollery CT. Clonidine withdrawal in hypertension. Changes in blood pressure and plasma and urinary noradrenaline. Lancet 1977; 1: 1171-4.
21. Whitsett TL. Abrupt cessation of treatment of centrally acting antihypertensive agents. A review. Chest 1983; 83: 400-2.
22. Ram CVS, Engelman K. Abrupt discontinuation of clonidine therapy. JAMA 1979; 242: 2104-5.
23. Hamilton BP, Mersey JH, Hamilton J, Kuzbida G, Pavlis R, Levisnon P. Withdrawal phenomena are subjects with essential hypertension on clonidine or tiamenidine. Clin Pharmacol Ther 1984; 36: 628-33.
24. Weber MA. Discontinuation syndrome following cessation of treatment with clonidine and other antihypertensive agents. J Cardiovasc Pharmacol 1980; 2 (Suppl. 1): S73-89.
25. Planz G, Beckenbauer U, Bundschu H. Response of plasma catecholamines and blood pressure to clonidine and to sudden withdrawal of the drug in subjects with essential hypertension. Int J Clin Pharmacol Ther Toxicol 1982; 20: 474-8.
26. Martin PR, Ebert MH, Gordon EK, Weingartner H, Kopin IJ. Catecholamine metabolism during clonidine withdrawal. Psychopharmacology (Berl) 1984; 84: 58-63.
27. Vincent D, Pradalier A. Pheochromocytoma-like catecholamine levels induced by clonidine cessation. Eur J Med 1993; 2: 313-4.
28. Hansson L, Hunyor SN, Julius S, Hoobler SW. Blood pressure crisis following withdrawal of clonidine (Catapres, Catapresan), with special reference to arterial and urinary catecholamine levels, and suggestions for acute management. Am Heart J 1973; 85: 605-10.
29. Strauss FG, Franklin SS, Lewin AJ, Maxwell MH. Withdrawal of antihypertensive therapy. Hypertensive crisis in renovascular hypertension. JAMA 1977; 238: 1734-6.
30. Burden AC, Alexander PCT. Rebound hypertension after acute methyldopa withdrawal. BMJ 1976; 1: 1056-7.
31. Scott JN, McDevit DG. Rebound hypertension after acute methyldopa withdrawal. BMJ 1976; 2: 367.
32. Cannon PJ, Whitlock RT, Morris RG, Angers MO, Laragh JM. Effects of alpha-methyldopa in severe and malignant hypertension. JAMA 1962; 179: 673-7.
33. Horwitz D, Pettinger WA, Orvis H, Thomas RE, Sjoerdsma A. Effects of methyldopa in fifty hypertensive patients. Clin Pharmacol Ther 1967; 8: 224-34.
34. Frewin DB, Penhall RK. Rebound hypertension after sudden discontinuation of methyldopa therapy. Med J Aust 1977; 1: 659.
35. Collberg AD, Raftery EB, Wilkinson P. Blood pressure and heart rate withdrawal of antihypertensive drugs. BMJ 1977; 1: 1243-6.
36. Conolly ME, Briant RH, George C, Dollery CT. A cross one comparison of clonidine and methyldopa in hypertension. Eur J Clin Pharmacol 1972; 1: 223-8.
37. Ram CV, Holland OB, Fairchild C, Gomez-Sanchez CE. Withdrawal syndrome following cessation of guanabenz therapy. J Clin Pharmacol 1979; 19: 148-50.
38. Dustan HP, Page IH, Tavazl RC, Frolich ED. Arterial pressure responses to discontinuing antihypertensive drugs. Circulation 1968; 37: 370-9.
39. Moser M. Guanethidine and bethanidine in the management of hypertension. Am Heart J 1969; 77: 423-6.
40. Stocks AE, Robertson A. The long-term therapy of severe hypertension with guanethidine. Am Heart J 1967; 73: 569-70.
41. Britov AN. The use of bethanidine sulfate (Esbatal) in hypertension. Kardiologiia 1966; 6: 57-60.
42. Leishman AW, Thirkettle JL, Allen BR. Bethanidine in hypertension. BMJ 1968; 1: 120.
43. Eichorn EJ. Beta-blocker withdrawal: the song of Orfeus. Am Heart J 1999; 138: 387-9.
44. Wolfson S, Heinle RA, Herman MV, Kemp HG, Sullivan JM, Gorlin R. Propanolol and angina pectoris. Am J Cardiol 1966; 18: 345-53.
45. Prichard BN, Walden RJ. The syndrome associated with the withdrawal of beta-adrenergic receptor blocking drugs. Br J Clin Pharmacol 1982; 13 (Suppl. 2): S337-43.
46. Moskowitz R, Kukin M. Current issues regarding beta-adrenergic blockade in patients with congestive heart failure: patient selection nonselective versus selective blockade, management of adverse effects and indications for withdrawal of therapy. Curr Cardiol Rep 1999; 1: 47-54.
47. Rangho RE, Langolois S. Comparison of withdrawal phenomena after propranolol, metoprolol and pindolol. Br J Clin Pharmacol 1982; 13 (Suppl. 2): S345-51.
48. Nattel S, Rango RE, van Loon G. Mechanism of propanolol withdrawal phenomena. Circulation 1979; 59: 1158-64.
49. Lichtman MA, Cohen I, Murphy MS. Effect of propanolol on oxygen binding to hemoglobin in vitro and in vivo. Circulation 1974; 49: 881-6.
50. Rango RE. Propanolol withdrawal. Practical considerations. Arch Intern Med 1981; 141: 161-2.
51. Morimoto S, Shimizu K, Yamada K, Hiramitsu S, Hishida H. Can beta-blocker therapy be withdrawn from patients with dilated cardiomyopathy. Am Heart J 1999; 138: 456-9.
52. Slome R. Withdrawal of propanolol and myocardial infraction. Lancet 1973; 1: 156.
53. Shenkman L, Podrid P, Lowenstein J. Hyperthyroidism after propanolol withdrawal. JAMA 1977; 238: 237-9.
54. Kristensen BO, Steiness E, Weeke J. Propanolol withdrawal and thyroid hormones in patients with essential hypertension. Clin Pharmacol Ther 1978; 23: 624-9.
55. Ross PJ, Lewis MJ, Sheridan DJ, Henderson AH. Adrenergic hypertensitivity after beta-blocker withdrawal. Br Heart J 1981; 45: 637-42.
56. Walden RJ, Bhattacharjee P, Tomlinson B, Cashin J, Graham BR, Prichard BN. The effects of intrinsic sympathomimetic activity on b-receptor responsiveness after b-adrenoceptor blockage withdrawal. Br J Clin Pharmacol 1982; 13 (Suppl. 2): S359-64.
57. Lederballe K, Pederson O, Mikelsen E. Beta-blocker withdrawal syndrome. Lancet 1979; 1: 554-5.
58. Frishman WH, Christodoulou J, Weksler B, Smithen C, Killip T, Sheidt S. Abrupt propanolol withdrawal in angina pectoris. Effects on platelet aggregation and exercise tolerance. Am Heart J 1978; 95: 169-79.
59. Myers MG, Freeman MR, Juma ZA, Wisenberg G. Propanolol withdrawal in angina pectoris. A prospective study. Am Heart J 1979; 97: 298-302.
60. Rangno RE. Stopping β-blockers in patients with angina. Ration Drug Ther 1981; 15: 1-4.
61. Goldman L. Non-cardiac surgery in patients receiving propanolol. Case reports and recommended approach. Arch Intern Med 1981; 141: 193-6.
62. Shiina H, Sugiyama Takahara A, Satoh Y, Hashimoto K. Comparison of the electropharmacological effects of verapamil and propranolol in the halothane-anesthetized in vivo canine model under monophasic action potential monitoring. Jpn Circ J 2000; 64: 777-82.
63. Nademanee K, Taylor R, Bailey WE, Rieders DE, Kosar EM. Treating electrical storm: sympathetic blockade versus advanced cardiac life support-guided therapy. Circulation 2000; 102: 742-7.
64. Halpin LS, Barnett SD, Burton NA. National databases and clinical practice specialist: decreasing postoperative atrial fibrillation following cardiac surgery. Outcomes Manag 2004; 8: 33-8.
65. Pettinger WA, Mitchell HC. Renin release, saralasin and the vasodilator-beta-blocker drug interaction in man. N Engl J Med 1975; 292: 1214-7.
66. Keim HJ, Drayer JI, Case DB et al. A role for rennin in rebound hypertension and encephalopathy after infusion of saralasin acetate (Sar-Ala8-angiotensin II). N Engl J Med 1979; 295: 1175-7.
67. Packer M, Meller J, Medina N, Gorlin R, Herman M. Rebound hemodynamic events after the abrupt withdrawal of nitroprusside in patients with severe chronic heart failure. N Engl J Med 1979; 301: 1193-7.
68. Francis GS, Olivan MT, Goldsmith SR, Levine TB, Pierpont G, Cohn JN. The acute response of plasma norepinephrine, renin activity, and arginine vasopressin to short-term nitroprusside and nitroprusside withdrawal in patients with congestive heart failure. Am Heart J 1983; 106: 1315-20.
69. Makker SP, Moorthy B. Rebound hypertension following minoxidil withdrawal. J Pediatr 1980; 96: 762-6.
70. Cohen J, Gutman Y. Effects of verapamil, dantrolene and lanthanum on catecholamine release from the rat adrenal medulla. Br J Pharmacol 1979; 65: 641-5.
71. Frishman WH, Charlap S, Kimmel B, Golberger J, Phillipides G, Klein N. Calcium-channel blockers for combined angina pectoris and systemic hypertension. Am J Cardiol 1986; 57: 22D-29D.
72. Bala Subramanian V. Clinical and research applications of ambulatory Holter ST-segment and heart rate monitoring. Am J Cardiol 1986; 58: 11B-20B.
73. Khurmi NS, Bowles MJ, O'Hara MJ, Bala Subramanian V, Raftery EB. Long-term efficacy of diltiazem assessed with multi-stage graded exercise tests in patients with chronic stable angina pectoris. Am J Cardiol 1984; 54: 738-43.
74. Bala Subramanian V, Khurmi NS, Bowles MJ, O'Hara M, Raftery EB. Objective evaluation of three dose levels of diltiazem in patients with chronic stable angina. J Am Coll Cardiol 1983; 1: 1144-53.
75. Dai H, Chen J, Tao Q et al. Effects of diltiazem on platelet activation and cytosolic calcium during percutaneous transluminal coronary angioplasty. Postgrad Med J 2003; 79: 522-6.
76. Hjemdahl P, Wallen NH. Calcium antagonist treatment, sympathetic activity and platelet function. Eur Heart J 1997; 18 (Suppl. A): A36-A50.
77. Vauer L, Borbie G, Dutrey-Dupagne I et al. Short-term effects of withdrawing angiotensin converting enzyme inhibitor therapy on home self-measured blood pressure in hypertensive patients. J Hypertens 1998; 11: 165-73.
78. Stephan D, Grima M, Welsch M, Barthelmeds M, Vasmant D, Imbs J. Interruption of prolonged ramipril treatment in hypertensive patients: effects on the rennin-angiotensin system. Fundam Clin Pharmacol 1996; 10: 474-83.
79. Schafer A, Fraccarollo D, Tas P, Schmidt I, Ertl G, Bauersachs J. Endothelial dysfunction in congestive heart failure: ACE inhibition vs. angiotensin II antagonism. Eur J Heart Fail 2004; 6: 151-9.