Table 3

Drugs, chemicals, poisons, and toxins causing autonomic dysfunction

Adapted from Mathias (2000) (see table 2 footnote).
Decreasing sympathetic activity
Centrally acting

  • –clonidine

  • –methyldopa

  • –moxonidine

  • –reserpine

  • –barbiturates

  • –anaesthetics

Peripherally acting

  • –sympathetic nerve endings (guanethidine, bethanidine)

  • –α adrenoceptor blockade (phenoxybenzamine)

  • –β adrenoceptor blockade (propranolol)

Increasing sympathetic activity

  • –amphetamines

  • –releasing noradrenaline (tyramine)

  • –uptake blockers (imipramine)

  • –monoamine oxidase inhibitors (tranylcypromine)

  • –β adrenoceptor stimulants (isoprenaline)

Decreasing parasympathetic activity

  • –antidepressants (imipramine)

  • –tranquillisers (phenothiazines)

  • –antidysrhythmics (disopyramide)

  • –anticholinergics (atropine, probanthine, benztropine)

  • –toxins (botulinum)

Increasing parasympathetic activity

  • –cholinomimetics (carbachol, bethanechol, pilocarpine, mushroom poisoning)

  • –anticholinesterases

  • –reversible carbamate inhibitors (pyridostigmine, neostigmine)

  • –organophosphorous inhibitors (parathion, sarin)

Miscellaneous

  • –alcohol, thiamine (vitamin B1) deficiency

  • –vincristine, perhexiline maleate

  • –thallium, arsenic, mercury

  • –mercury poisoning (pink disease)

  • –ciguatera toxicity

  • –jellyfish and marine animal venoms

  • –first dose of certain drugs (prazosin, captopril)

  • –withdrawal of chronically used drugs (clonidine, opiates, alcohol)