Myocardial Irritability Associated with Lithium Carbonate Therapy

Lithium causing a serious sinus‐node dysfunction at therapeutic doses

“…These symptoms disappeared after withdrawal of lithium. However, in contrast with some other cases, we did not observe a modification of the QT interval (Giard, 1980), nor any troubles of the supraventricular (except for sinus bradycardia) or ventricular rhythm (Tangedahl et al, 1972), nor any ventricular conduction impairment. After having studied the intervals between the P waves, it was impossible to classify the bradycardia as a sinoauricular block.…”

Vasopressin Function in the Syndrome of Inappropriate Antidiuresis

“…Lithium causes nephrogenic diabetes insipidus in about 20% of people with normal antidiuretic function (91) and has been used to correct hyponatremia in patients with inappropriate antidiuresis (92). However, it is effective in only a minority of patients, and its several toxic side effects including sluggish ness, tremor, gastrointestinal disturbances, cardiotoxicity, and thyroid dys function severely limit its use (93)(94)(95).…”

The Role of Trazodone in the Treatment of Depressed Cardiac Patients

“…First, the monoamine oxidase inhibi tors (MAOI) became contraindicated for de pressed cardiac patients because of their food and drug interactions, even though in certain circumstances the MAOI lower blood pres sure and increase coronary artery blood flow -pharmacologic characteristics that could prove most useful for certain compliant sub groups of cardiac depressives [1,2], Next, data derived from animal studies and from cases of suicide or peri-suicide committed by means of tri-tetracyclic overdose were used to overstate the cardiovascular dangers of this group of medications [3][4][5]. Then, lith ium salts were implicated in cardiopathology [6][7][8], Yet, there is still no absolute contrain dication to their use in bipolar patients with heart disease. Recently, even trazodone, an antidepressant which came onto the market with a reputedly benign cardiovascular pro file, has been reported as potentially cardio toxic [9], In an important anecdotal study, Janowsky et al [9] have described 2 subjects whose preexisting ventricular arrhythmias were aggravated after beginning trazodone treatment for their depressions.…”