Do antidepressants cause postural hypotension by blocking cardiovascular reflexes?

Postural changes in blood pressure, respiratory sinus arrhythmia, the heart rate response to Valsalva's manoeuvre and to standing, and the blood pressure and heart rate responses to isometric exercise have been measured in seven young women taking antidepressant medication and compared with seven controls. Among the patients there was a significant rank order correlation between the degree of postural hypotension and the daily dose of antidepressant medication. There was a significant impairment among the patients of all cardiovascular reflex responses measured, suggesting both cholinergic and adrenergic blockade. These results suggest that postural hypotension associated with antidepressant medication is caused in large part by a failure of reflex peripheral vasoconstriction.

A case of Klinefelter's syndrome with acquired hypopituitarism.

The association of Klinefelter's syndrome (KS) and hypopituitarism has been described in previous isolated case reports, in most of which the hypopituitarism was partial. A case is described of a man with KS who acquired hypopituitarism in adult life. The diagnosis of KS was made at the age of 25 years on standard laboratory tests when he presented with failure of ejaculation and typical clinical features. Thirteen years later he presented with anaemia and further regression of secondary sexual characteristics. All aspects of anterior pituitary function were abnormal. The cause of the hypopituitarism was not determined, but may have been post-traumatic.

Basilar artery aneurysm and Anderson-Fabry disease.

A case of basilar artery aneurysm is described. The patient had a family history of similar aneurysms and also of a rare spingolipidosis, Anderson-Fabry disease.