Pseudoephedrine bromocriptine

Psychosis has been described in a 19-year-old postpartum woman who took bromocriptine and pseudoephedrine (28). 

Reeves RR, Pinkofsky HB. Postpartum psychosis induced by bromocriptine and pseudoephedrine. J Fam Pract 1997 45(2) 164-6. 

Trade names Apo-Bromocriptine Bromed Cryocriptina Kripton Parilac Parlodel (Novartis) Pravidel Serocryptin Indications Amenorrhea, parkinsonism, infertility Category Dopamine receptor agonist Half-life initial 6-8 hours terminal 50 hours Clinically important, potentially hazardous interactions with erythromycin, lanreotide, pseudoephedrine, sympathomimetics... 

A healthy postpartum woman taking bromocriptine developed very severe headache and marked hypertension after also taking phenylpropanolamine. Similarly another woman developed seizures with cerebral vasospasm, and a third developed a severe headache, hypertension and severe cardiac dysfunction after also taking isometheptene. A further patient taking bromocriptine developed psychosis when pseudoephedrine was added. 

A woman who had recently given birth and who had taken bromocriptine 2.5 mg twice daily for 9 days without problems became psychotic shortly after starting to take pseudoephedrine 60 mg four times daily. ... 

Not understood. Severe hypertension occasionally occurs with either bromocriptine or phenylpropanolamine given alone. Shortly after giving birth some individuals show increased vascular reactivity, and it could be that all of these factors conspired together to cause these adverse effects. Psychosis occasionally occurs after giving birth or on bromocriptine alone, so that in the latter case the addition of pseudoephedrine may have been coincidental. ... 

---