Antidepressants
- PDF / 141,836 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 40 Downloads / 154 Views
1
S
Sinus node dysfunction: case report A 25-year-old man with major depression and a history of drug abuse developed sinus node dysfunction during treatment with venlafaxine, olanzapine, mirtazapine and sertraline. The man presented after experiencing three episodes of syncope over a 2-month period. He had a 5-year history of drug and alcohol abuse, including cannabis use 1–2 times weekly and ecstasy use of 7–8 tablets weekly. He had not taken recreational drugs or alcohol in the 6 months leading up to presentation. For treatment of major depression, he had received extended-release venlafaxine 150 mg/day for 8 months, sertraline 50 mg/day* for 4 months, olanzapine 5 mg/day** for 3.5 months and mirtazapine 30 mg/day for 2 months [routes not stated]. Following admission, 53 episodes of sinusal pauses lasting 2.5–6.8 seconds were recorded during overnight monitoring. His HR ranged between 28 and 98 beats/min. Electrophysiological studies revealed prolonged basal intracardiac intervals with an AH duration of 82 msecs, an HV duration of 54 msecs, an AVWenckebach duration of 320 msecs and a corrected sinus node recovery time of 680 msecs. Permanent sinus node dysfunction due to previous drug abuse was suspected. A pacemaker was implanted. No further episodes of syncope occurred and the man was discharged. Author comment: "All drugs used by our patient have bradycardia and syncope as reported side effects. When all drugs used by our patient are considered, the cause of SA node dysfunction in our patient seems to caused by both an intrinsic disruption of SA node along with autonomic dysfunction." * dosage of sertraline reported as 100 mg/day elsewhere in the paper ** dosage of olanzapine reported as 10 mg/day elsewhere in the paper Hasdemir H, et al. Multi drug abuse and sinus node dysfunction. HealthMED 6: 803075911 1348-1350, No. 4, 2012 - Turkey
0114-9954/10/1416-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 25 Aug 2012 No. 1416
Data Loading...
