Three previous case reports have described hemodynamic abnormalities precipitated or triggered by imipramine therapy and leading to recognition of pheochromocytoma (1-3). It has been uncertain whether therapy with other tricyclic antidepressants may unmask pheochromocytoma. We describe the unmasking of pheochromocytoma by desipramine therapy in a patient who showed no adverse effect while receiving amitriptyline intermittently over 9 years.
A 56-year-old woman presented with a history of severe headache and nausea with vomiting for 2 days. Her symptoms had begun after two doses of desipramine (Norpramin, Merrell-National Laboratories, Cincinnati, Ohio), 25 mg, and ketoprofen (Orudis, Poulenc, Ltd., Montreal, Quebec, Canada). She