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Jerry F. Meyer, MD; C. Kenneth McAllister, MD; Leon I. Goldberg, PhD, MD

JAMA. 1970;213(9):1487-1488.

Abstract
A hypersensitive, 47-year-old man was adequately treated with guanethidine sulfate, 75 mg/day. Because of depression he was treated with amitriptyline hydrochloride, 25 mg, three times daily, and 300 mg of guanethidine sulfate was required for adequate control. Administration of amitriptyline was discontinued and the patient experienced pronounced orthostatic hypotension with 87.5 mg of guanethidine sulfate daily. After five days of amitriptyline hydrochloride therapy, 150 mg/day, the effects of guanethidine were again eliminated. The hypotensive effect of guanethidine did not return until 18 days after amitriptyline therapy was discontinued.

Author Affiliations
From the Department of Medicine (Division of Clinical Pharmacology), Emory University School of Medicine; and the Medical Service, Grady Memorial Hospital, Atlanta.

Footnotes
Reprint requests to 69 Butler St SE, Atlanta 30303 (Dr. Goldberg).

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