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All the catecholamines and metabolites appear to be increasing with the urine collections. Firstly one should examine the 24h creatinine results to ascertain that all the collections are for the same time period. The predominant increase is in HVA, the metabolite of dopamine. This patient is on Moxonidine, which acts on alpha2adrenoreceptor and doxazocin which is an alpha blocker. These drugs or the combination may act as dopamine antagonists. I suggest that both these drugs be stopped and the 24h urine collections be repeated off medication. Dr Jeffrey Barron Department of Chemical Pathology St Helier Hospital Carshalton Surrey SM5 1AA UK [log in to unmask] Tel 0181 296 2660 Fax 0181 641 2633 Fax 0181 641 2633 0181 296 2660 %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%