Venlafaxine
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Severe rhabdomyolysis: case report A 21-year-old woman developed severe rhabdomyolysis following treatment with low-dose venlafaxine for bipolar depression. The woman received extended-release venlafaxine 37.5 mg/day [route not stated] alongside valproic acid. She was switched to venlafaxine from sertraline following worsening social interaction. She presented 9 days after initiation of venlafaxine with mild pain over her lower legs which appeared to be worsening. Other than the lower leg pain her physical and neurological examinations were normal. Laboratory tests revealed a severely elevated plasma creatine kinase level of 18 711 U/L and elevated transaminase levels. Urinalysis revealed haematuria. Her serum valproic acid level was subtherapeutic at 14.71 µg/mL (therapeutic range 50–100 µg/mL). Venlafaxine-induced rhabdomyolysis was suspected. The woman was treated with hydration and bicarbonate infusion. Her creatine kinase level decreased gradually to 6765 U/L and she was discharged on hospital day 5 [outcome not stated]. Author comment: "We concluded that the raised plasma [creatine kinase] level in our patient was attributable to direct muscle injury caused by venlafaxine". Huang S-S, et al. Low-dose venlafaxine-induced severe rhabdomyolysis: A case report. General Hospital Psychiatry 34: 436e5- 436e7, No. 4, Jul-Aug 2012. Available from: URL: http://dx.doi.org/10.1016/j.genhosppsych.2012.01.016 803075990 Taiwan
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Reactions 25 Aug 2012 No. 1416
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