Blood Pressure Over-Shoot Due to Acute Clonidine (Catapres) Withdrawal: Studies on Arterial and Urinary Catecholamines and Suggestions for Management of the Crisis

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Abstract
1. Clonidine was withdrawn acutely in five hypertensive patients with a documented blood pressure over-shoot after previous temporary cessation of treatment. 2. In all patients a severe rise of systolic and diastolic blood pressure was seen (average 67/58 mmHg). This was accompanied by a number of ‘withdrawal symptoms’, e.g. restlessness, tremor, headaches and nausea. 3. Catecholamines in urine rose from 32 μg/l to 112 μg/l (001 < P < 0.02) and in arterial blood from 0.52 μg/l to 1.0 μg/l (not significant). 4. The crisis could be reversed acutely by α- and β-adrenergic blockade. 5. Catecholamine depletion with reserpine before the withdrawal of clonidine seemed to reduce the blood pressure rise and the withdrawal symptoms.

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