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Pheochromocytoma Unmasked by Amisulpride and Tiapride

Clinical Pharmacist, Pharmacy Department, Croix-Rousse Hospital, Lyon, France

Bruno Charpiat, PharmD

Clinical Pharmacist, Pharmacy Department, Croix-Rousse Hospital

Thierry Vial, MD

Clinical Pharmacologist, Regional Pharmacovigilance Center, Lyon

Serge Franchini, MD

Emergency Department, Croix-Rousse Hospital

François J Cuilleret, MD

Department of Cardiology, Croix-Rousse Hospital

Hugues Milon, MD

Professor of Cardiology, Department of Cardiology, Croix-Rousse Hospital

Reprints: Dr. Henry, Pharmacy Department, Croix-Rousse Hospital, 103 grande rue de la Croix-Rousse, 69317 Lyon Cedex 04, France, fax 33 4.72.07.18.94, agnes.henry{at}chu-lyon.fr

OBJECTIVE: To describe the unmasking of pheochromocytoma in a patient treated with amisulpride and tiapride.

CASE SUMMARY: A 42-year-old white man developed acute hypertension with severe headache and vomiting 2 hours after the first doses of amisulpride 100 mg and tiapride 100 mg. Both drugs were immediately discontinued, and the patient recovered after subsequent nicardipine and verapamil treatment. Abdominal ultrasound showed an adrenal mass, and postoperative histologic examination confirmed the diagnosis of pheochromocytoma.

DISCUSSION: Drug-induced symptoms of pheochromocytoma are often associated with the use of substituted benzamide drugs, but the underlying mechanism is unknown. In our case, use of the Naranjo probability scale indicated a possible relationship between the hypertensive crisis and amisulpride and tiapride therapy.

CONCLUSIONS: As of March 24, 2005, this is the first reported case of amisulpride- and tiapride-induced hypertensive crisis in a patient with pheochromocytoma. Physicians and other healthcare professionals should be aware of this potential adverse effect of tiapride and amisulpride.

Key Words: amisulpride, pheochromocytoma, tiapride

Published Online, April 5, 2005. www.theannals.com, DOI 10.1345/aph.1E510