Procainamide-induced psychosis: a case report and review of the literature.
OBJECTIVE
To describe a case of procainamide-induced psychosis in an adult treated for atrial fibrillation.


METHODS
A 45-year-old Native American woman developed acute psychosis within 72 hours of initiating procainamide for atrial fibrillation. Symptoms abated within 24 hours of discontinuing procainamide. Serum procainamide/N-acetylprocainamide concentrations were therapeutic throughout treatment. Sotalol was started without recurrence of symptoms.


CONCLUSIONS
Psychosis is a rare complication of treatment with procainamide, but the exact mechanism for this adverse event is not fully understood. Seven cases implicating procainamide as the cause of acute psychosis are reported in the literature. Cases of psychosis involving other antiarrhythmic agents have also been reported.


CONCLUSIONS
Healthcare personnel should be aware of this adverse event related to procainamide and other antiarrhythmic agents.
Bizjak
E D
ED
College of Pharmacy, The University of Arizona, Tucson 85721, USA.
Nolan
P E
PE
Brody
E A
EA
Galloway
J M
JM
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011342:Procainamide / Q000009:adverse effects* / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000209:etiology*
D000889:Anti-Arrhythmia Agents; D011342:Procainamide