Atrioventricular nodal re-entrant tachycardia associated with stimulant treatment.
A 13-year-old African-American female taking sertraline for obsessive compulsive disorder was diagnosed with her first episode of atrioventricular (AV) nodal re-entrant tachycardia five days after beginning Mixed Salts of a Single-Entity Amphetamine Product (Adderall) for treatment of attention-deficit hyperactivity disorder (ADHD). She received successful cardioversion with 6 mg of intravenous adenosine, but developed a second episode of possible AV nodal re-entrant tachycardia twelve days after Adderall was reinitiated at half the previous dose. The patient had clinically similar cardiac episodes five and six months after treatment was changed to slow-release methylphenidate. Stimulant medication may evoke onset of AV nodal tachyarrhythmias in patients who have the potential to develop them, possibly in combination with a selective serotonergic reuptake inhibitor (SSRI).
Gracious
B L
BL
Division of Child Psychiatry, Case Western Reserve University, University Hospitals of Cleveland, Ohio 44106, USA.
D000293:Adolescent; D000662:Amphetamines / Q000009:adverse effects*; D017115:Catheter Ablation; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000139:chemically induced* / Q000601:surgery
C090411:Adderall; D000662:Amphetamines; D000697:Central Nervous System Stimulants; D008774:Methylphenidate