Seizures, Ventricular Tachycardia, and Rhabdomyolysis as a Result of Ingestion of Venlafaxine and Lamotrigine

Peano, Claudia; Leikin, Jerrold B.; Hanashiro, Paul K.

doi:10.1016/s0196-0644(97)70093-3

Cited by 43 publications

(26 citation statements)

References 16 publications

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“…Previous reports suggest that venlafaxine does not have the sodium channel toxicity manifested by the TCA [3]. However, one potential mechanism for the cardiac toxicity observed with venlafaxine may relate to sodium channel poisoning.…”

Section: Discussionmentioning

confidence: 92%

“…At therapeutic doses, it has minor effects on the reuptake of norepinephrine and dopamine, which is probably not clinically relevant [1]. Venlafaxine overdose has been reported to cause seizures, dysrythmias, central nervous system (CNS) depression, and hypotension [3,8].…”

Section: Discussionmentioning

confidence: 99%

“…It is structurally more closely related to tramadol, a non-opioid analgesic, than it is to tricyclic antidepressants (TCA), monoamine oxidase inhibitors (MAOI), or selective serotonin reuptake inhibitors (SSRI) [1,2]. It reportedly does not have the sodium channel blocking properties of TCA, thereby resulting in fewer cardiac side effects [3]. Due to its primary action of serotonin reuptake inhibition, toxic effects after overdose are likely to be similar to those seen with SSRI.…”

Section: Introductionmentioning

confidence: 99%

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A fatal case of venlafaxine overdose

2008

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Introduction: Based on its primary action of serotonin reuptake inhibition, venlafaxine overdose would be expected to result in serotonergic effects.Case Report: A 40 year old male ingested venlafaxine without co-ingestants in a suicide attempt. The patient developed refractory ventricular fibrillation and expired approximately 9 hours post-ingestion. ECG monitoring revealed significant QRS and QT C interval prolongation prior to his demise.Discussion: A literature review of venlafaxine overdose cases and investigation into its mechanism of action was conducted. The potential for sodium channel blockade and implications for therapy are discussed.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A fatal case of venlafaxine overdose

2008

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“…Drug overdose with venlafaxine in humans has been associated with hypotension and sinus tachycardia [Peano et al, 1997;Rosen et al, 1997]. In addition, widening of the QRS interval has been seen in some patients [Kokan and Dart, 1996].…”

Section: Cardiovascularmentioning

confidence: 99%

Neuropharmacology of venlafaxine

Roseboom¹,

Kalin²

2000

Depress. Anxiety

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“…5 Another report described ventricular arrhythmia associated with a mixed ingestion of venlafaxine and lamotrigine. 6 Additionally, a postmortem investigation by Pricone and colleagues found "supratherapeutic" concentrations of lamotrigine in several cases of intentional overdose and coingestion of other medications, particularly valproic acid. 7 In this case, ECG changes commonly associated with the sodium-channel blocking effects of TCAs were seen.…”

Section: Discussionmentioning

confidence: 99%

Lamotrigine as a possible cause of QRS prolongation in a patient with known seizure disorder

Herold

2006

CJEM

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Lamotrigine and felbamate are 2 newer anticonvulsant medications used to control refractory partial and generalized seizures. Although several cases of lamotrigine toxicity secondary to acute intentional or unintentional overdose have been described, there is little published information related to potential side-effects associated with the therapeutic use of these agents. Described is a case of a 22-year-old woman who presented to the emergency department after experiencing 2 seizure-like episodes. Findings on evaluation included nystagmus, ataxia, widening of the QRS complex and right-axis deviation on ECG. The patient reported only therapeutic use of her medications. The lamotrigine level was 14.8 mg/L. The mechanism of action for lamotrigine is blockade of the sodium channels; therefore, the patient was treated with intravenous sodium bicarbonate with resultant QRS narrowing following administration. RÉSUMÉLa lamotrigine et le felbamate sont deux antiépileptiques plus récents utilisés pour maîtriser les crises d'épilepsie partielles et généralisées réfractaires. Bien que plusieurs cas de toxicité de la lamotrigine secondaire à une intoxication aiguë intentionnelle ou non intentionnelle aient été décrits, il existe peu d'information publiée relative aux effets indésirables possibles associés à l'usage thérapeutique de ces agents. Nous décrivons le cas d'une jeune femme de 22 ans qui s'est présentée à l'urgence après avoir été victime de deux épisodes ressemblant à des crises d'épilep-sie. Les constatations lors de l'évaluation incluaient un nystagmus, de l'ataxie, un élargissement du complexe QRS et une déviation axiale droite à l'ECG. La patiente dit n'avoir utilisé ses médica-ments qu'à des doses thérapeutiques. Le niveau de lamotrigine était de 14,8 mg/L. Le mécanisme d'action de la lamotrigine est le blocage des canaux sodiques; par conséquent, la patiente fut traitée à l'aide de bicarbonate de sodium intraveineux, qui eut pour effet de provoquer le rétré-cissement du complexe QRS.

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Seizures, Ventricular Tachycardia, and Rhabdomyolysis as a Result of Ingestion of Venlafaxine and Lamotrigine

Cited by 43 publications

References 16 publications

A fatal case of venlafaxine overdose

A fatal case of venlafaxine overdose

Neuropharmacology of venlafaxine

Lamotrigine as a possible cause of QRS prolongation in a patient with known seizure disorder

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