title: Postictal ventricular tachycardia after electroconvulsive therapy treatment associated with a lithium-duloxetine combination.
abstract: This report addresses the dilemma of continuing lithium prophylaxis and antidepressant therapy in view of cardiovascular adverse effects under electroconvulsive therapy (ECT) in patients with a long history of recurrent affective disorders. A severely depressed 48-year-old woman who had been treated with lithium for 18 years developed a ventricular tachycardia during ECT. Possible interaction with succinylcholine was taken into account, and rocuronium was used as an alternative muscle relaxant. Electroconvulsive therapy was continued without adverse effects after reduction of lithium and withdrawal from duloxetine. Systemic studies on cardiac adverse effects of serotonin and norepinephrine reuptake inhibitors and serotonin and norepinephrine reuptake inhibitor-lithium combinations during ECT are needed.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University, Hospital for Psychiatry, Lenggstrasse 31, Postfach 1931, CH-8032 Zürich, Switzerland. heinz.boeker@bli.uzh.ch
authors.forename: Boeker
authors.initials: B
authors.lastname: Heinz
authors.forename: Perniola
authors.initials: P
authors.lastname: Lorenzo
authors.forename: Risch
authors.initials: R
authors.lastname: Markus
authors.forename: Himmighoffen
authors.initials: H
authors.lastname: Holger
authors.forename: Roemer
authors.initials: R
authors.lastname: Beatrix
authors.forename: Seifritz
authors.initials: S
authors.lastname: Erich
authors.forename: Borgeat
authors.initials: B
authors.lastname: Alain
mesh_terms: D000732:Androstanols; D000758:Anesthesia; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000628:therapy; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D000068736:Duloxetine Hydrochloride; D004562:Electrocardiography; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D011595:Psychomotor Agitation / Q000209:etiology; D012008:Recurrence; D000077123:Rocuronium; D013390:Succinylcholine; D017180:Tachycardia, Ventricular / Q000209:etiology*; D013876:Thiophenes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000732:Androstanols; D000928:Antidepressive Agents; D018692:Antimanic Agents; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D013876:Thiophenes; D016651:Lithium Carbonate; D000068736:Duloxetine Hydrochloride; D013390:Succinylcholine; D000077123:Rocuronium