Mirtazapine
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Long QT syndrome: case report An 83-year-old man developed long QT syndrome (LQTS) during treatment with mirtazapine for major depressive disorder. The man, who had major depressive disorder, had been treated in an outpatient clinic. He had a history of paroxysmal atrial fibrillation. He did not have any family history of congenital LQTS or a sudden death. He received mianserin for major depressive disorder at at outpatient clinic. His 12-lead electrocardiography (ECG) in June 2016 revealed a corrected QT interval (QTc) of 472ms. He was hospitalised with worsening of depressive symptoms in May 2019. Treatment with mianserin was stopped. He then received mirtazapine 15mg per day [route not stated] after hospitalisation. Upon hospitalisation, his baseline QTc was 498ms. On day 4, his QTc prolonged to 554ms. Mirtazapine treatment was discontinued immediately. The QT interval was observed using a continuous three lead ECG. On day 5, the man received electroconvulsive therapy (ECT) for depression. The QTc reduced to 450ms on day 14. His initial laboratory investigation revealed acute renal failure, low serum albumin, high serum potassium and severe dehydration. No other electrolyte imbalances were reported. His thyroid and liver functions were normal. Chest X-ray was normal. After the sixth session of bilateral ECT, he achieved depression remission. Matsuda Y, et al. Mirtazapine-induced long QT syndrome in an elderly patient: a case report. Psychogeriatrics 20: 536-537, No. 4, Jul 2020. Available from: URL: http:// 803499501 doi.org/10.1111/psyg.12520
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Reactions 5 Sep 2020 No. 1820
