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[Unmasking pheochromocytoma by amitriptyline]
1Psychiatrische Universitätsklinik, Münster.
Der Nervenarzt
|April 2, 1998
Summary
Amitriptyline, an antidepressant, can unmask pheochromocytoma. Increasing the dosage to 150 mg/day in a patient with major depression led to symptoms like hypertension, revealing an underlying pheochromocytoma.
Area of Science:
- Pharmacology
- Endocrinology
- Oncology
Background:
- A 57-year-old woman diagnosed with major depression, melancholic subtype, was treated with amitriptyline.
- Initially, 75 mg/day of amitriptyline caused no adverse effects.
Observation:
- Upon increasing the dosage to 150 mg/day, the patient experienced "head spasms," headache, profuse sweating, and arterial hypertension.
- These symptoms were transient and resolved after dosage reduction.
Findings:
- The patient was diagnosed with pheochromocytoma, an adrenal tumor.
- Surgical removal of the adrenal gland (adrenalectomy) was performed.
- This case represents the first documented instance of amitriptyline unmasking pheochromocytoma.
Implications:
- The findings suggest a potential link between amitriptyline dosage and the manifestation of pheochromocytoma symptoms.
- Clinicians should consider pheochromocytoma in patients presenting with unexplained hypertension and other symptoms during amitriptyline treatment, especially with dosage increases.
- This highlights the importance of considering drug-induced symptom unmasking in diagnosing rare conditions.