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• W3199931457 abstract "There is no widely recognized preventive treatment for patients with paroxysmal hypertension (pseudopheochromocytoma) who suffer recurrent and often severe paroxysmal elevation of blood pressure, repeated emergency room visits and, in many cases, hospitalizations. In this case series we assessed the effectiveness of treatment with an antidepressant in preventing recurrent paroxysms. A secondary exploratory objective was to examine the psychological profile of patients with paroxysmal hypertension and its relationship to response to treatment. Medical records of patients seen between 2004 and 2019 with a diagnosis of paroxysmal hypertension were reviewed; the effectiveness in preventing paroxysms was assessed in those treated with an antidepressant. The charts of 66 patients with who reported having experienced at least 3 symptomatic episodes characterized by sudden onset of symptoms and blood pressure elevation that was not related to perceived emotional distress were selected. Of these, treatment follow-up data were available in 52. Treatment with an antidepressant was offered to 37 patients. Two patients refused treatment, 6 were unable to tolerate an effective dose, 3 were lost to follow-up, and 1 was non-compliant with the medication. Of the remaining 25 evaluable patients, 92% (23/25) responded, with 80% (21/25) achieving complete and persisting cessation of paroxysms, and 8% (2/25), a reduction in frequency. Importantly, an antidepressant was effective in nearly all patients who reported that they were not suffering from anxiety or depression. The data were insufficient to determine superiority of any one antidepressant versus another. We conclude that treatment with an antidepressant is effective in preventing hypertensive paroxysms in a high proportion of patients with paroxysmal hypertension. Given the absence of any other pharmacologic intervention capable of preventing recurrent paroxysms, the similarly high response rate observed in previous reports, and the relatively safe profile of antidepressant agents, the findings support more widespread use of an antidepressant in patients with this disorder to prevent years of continued hypertensive paroxysms and their consequences." @default.
• W3199931457 created "2021-09-27" @default.
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• W3199931457 date "2021-09-15" @default.
• W3199931457 modified "2023-09-25" @default.
• W3199931457 title "High Response Rate to Antidepressants in the Management of Paroxysmal Hypertension (Pseudopheochromocytoma)" @default.
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• W3199931457 doi "https://doi.org/10.1101/2021.09.10.21261667" @default.
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