Quetiapine
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Pedal oedema and sinus bradycardia: case report A 55-year-old man with schizoaffective disorder developed pedal oedema and sinus bradycardia during treatment with quetiapine. The man received quetiapine 800 mg/day [route not stated] in addition to valproic acid, clonazepam and biperiden. After 5 weeks of treatment he reported headache, dizziness and bilateral pedal oedema. His BP was normal but he had a reduced heart rate of 52bpm with normal conduction times. Two weeks after his symptoms appeared, the man’s quetiapine dose was reduced to 600 mg/day and risperidone was added to his treatment regimen. The dose was further reduced to 400 mg/day a week later with complete resolution of his pedal oedema; however, bradycardia remained problematic. Nearly 4 weeks after symptom onset, the dose was again reduced to 200 mg/day, with improvement of bradycardia within 24 hours. Quetiapine was eventually discontinued altogether and, at 10 months follow-up, there was no evidence of further oedema or sinus bradycardia. Author comment: "The temporal correlation suggested that the bradycardia was largely related to the use of quetiapine . . . blockage of α1, M1, H1 and 5-HT2 receptors may lead to peripheral vasodilatation and edema." Chen H-K, et al. Concurrent pedal edema and sinus bradycardia associated with quetiapine. Psychiatry and Clinical Neurosciences 65: 537-538, No. 5, Aug 2011. Available from: URL: http://dx.doi.org/10.1111/j.1440-1819.2011.02232.x 803061325 Taiwan
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Reactions 15 Oct 2011 No. 1373
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