An acute ischaemic event associated with the use of venlafaxine: a case report and proposed pathophysiological mechanisms.
Venlafaxine, a structurally novel antidepressant, belongs to a new generation of antidepressants--the serotonin/noradrenaline reuptake inhibitors. In clinical trials, venlafaxine was found safe and effective in most patients. However, significant changes in vital signs (hyper- and hypotension) and cardiac conduction abnormalities were observed in a few patients, notably in elderly patients. We present a case of an elderly woman with a pre-existing history of ischaemic heart disease, who was treated with venlafaxine, and developed acute myocardial ischaemia within the first week of treatment. This is the first report of a possible association between an acute cardiovascular event and venlafaxine. The association of venlafaxine treatment with ischaemic events could be explained by its unique pharmacological and haemodynamic properties.
Reznik
I
I
Abarbanel Mental Health Centre, Rabin Medical Centre-Beilinson Campus, Petah-Tikva, Israel. ilyarez@netvision.net.il
Rosen
Y
Y
Rosen
B
B
D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D003511:Cyclohexanols / Q000008:administration & dosage / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D009638:Norepinephrine / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D012701:Serotonin / Q000502:physiology; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D012701:Serotonin; D000069470:Venlafaxine Hydrochloride; D009638:Norepinephrine