Neuroleptic-Induced Brugada Syndrome - A Case Report

Laboudi, Fouad; Slimani, Ghizlane; Gourani, Mohamed Essaid; Ouanass, Abderrazzak

doi:10.15342/ijms.v5ir.189

Cited by 1 publication

(2 citation statements)

References 15 publications

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“…Ukaigwe and colleagues [ 64 ] also document a 49-year-old who developed the Brugada type 1 ECG pattern after initiation of clozapine, which resolved within 24 h after discontinuation. Finally, Laboudi and colleagues [ 65 ] report risperidone (4 mg/d) induced a Brugada type 1 ECG pattern in a 25-year-old with schizophrenia, with no cardiac history or familial history of sudden cardiac death. Discontinuation of risperidone resolved the abnormal ECG [ 65 ].…”

Section: Considerations For Pharmacotherapymentioning

confidence: 99%

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Pathogenesis and management of Brugada syndrome in schizophrenia: A scoping review

Rastogi

Viani-Walsh

Akbari

et al. 2020

General Hospital Psychiatry

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Context Excess cardiovascular morbidity and an increased prevalence of sudden cardiac death (SCD) contributes to premature mortality in schizophrenia. Brugada syndrome (BrS) is an important but underrecognized cause of SCD. It is more commonly seen in schizophrenia than in general population controls. Methods We conducted a scoping review to describe the pathogenesis of BrS in schizophrenia and to identify the psychotropic medications that increase the risk of unmasking BrS and associated ventricular arrhythmias resulting in SCD. Findings Schizophrenia and BrS share similar calcium channel abnormalities, which may result in aberrant myocardial conductivity. It remains uncertain if there is a genetic pre-disposition for BrS in a subset of patients with schizophrenia. However, the unmasking of Brugada ECG patterns with the use of certain antipsychotics and antidepressants increases the risk of precipitating SCD, independent of QT prolongation. Conclusions and future directions Specific cardiology assessment and interventions may be required for the congenital or unmasked Brugada ECG pattern in schizophrenia. The current long-term standard of care for BrS is an implantable cardioverter defibrillator (ICD), but post-implantation psychological effects must be considered. Careful use of antipsychotic and other psychotropic medications is necessary to minimize proarrhythmic effects due to impact on cardiac sodium and calcium ion channels. When prescribing such drugs to patients with schizophrenia, clinicians should be mindful of the potentially fatal unmasking of Brugada ECG patterns and how to manage it. We present recommendations for psychiatrists managing this patient population.

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Section: Considerations For Pharmacotherapymentioning

confidence: 99%

“…Finally, Laboudi and colleagues [ 65 ] report risperidone (4 mg/d) induced a Brugada type 1 ECG pattern in a 25-year-old with schizophrenia, with no cardiac history or familial history of sudden cardiac death. Discontinuation of risperidone resolved the abnormal ECG [ 65 ].…”

Section: Considerations For Pharmacotherapymentioning

confidence: 99%