Sudden chest pain with sertraline

Iruela, Luis M.

doi:10.1016/s0140-6736(94)90221-6

Cited by 8 publications

(5 citation statements)

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“…Serotonin is known to cause transient vasoconstriction of coronary vessels, particularly in those with atherosclerotic-related endothelial damage. 11 This victim may have suffered from acute coronary vasospasm immediately before death. There has been 1 case documented in the literature in which a 52-year-old male physician with a history of heart disease developed precordial chest pain with sertraline ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…There has been 1 case documented in the literature in which a 52-year-old male physician with a history of heart disease developed precordial chest pain with sertraline ingestion. 11 Of additional significance is the fact that sertraline has been associated with alterations in cardiac rhythm. Although rare, prolongation of the QT interval in particular has been described in 1 case of sertraline overdose.…”

Section: Discussionmentioning

confidence: 99%

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Fatal Intoxication With a Selective Serotonin Reuptake Inhibitor, Lorazepam, and Codeine

Filter¹,

Gorczynski²,

Fernandes³

2007

American Journal of Forensic Medicine &Amp; Pathology

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Selective serotonin reuptake inhibitors were introduced in 1987 as an alternative treatment option for patients with depression or certain anxiety disorders. Unfortunately, this greater use has prompted a corresponding increase in reports of more severe side effects and fatalities, with a majority of fatalities occurring due to coingestion of selective serotonin reuptake inhibitors with other substances or serotonergic drugs. We report a case which exemplifies one such fatality related to sertraline, lorazepam, and codeine coingestion. A brief discussion of the presumed mechanism by which death occurred will be offered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatal Intoxication With a Selective Serotonin Reuptake Inhibitor, Lorazepam, and Codeine

Filter¹,

Gorczynski²,

Fernandes³

2007

American Journal of Forensic Medicine &Amp; Pathology

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“…Un sta ble an gina has been re ported as an ADR of SSRIs, par ticu larly in pa tients with coro nary ar tery dis ease (CAD) (11). The most commonly pro posed mecha nism for this is that se ro tonin produces un op posed vaso con stric tion in athe ro scle rotic coro nary ar ter ies (11,21). Nor mally, when se ro tonin binds to 5-HT 1 re cep tors on vas cu lar en do the lium it stimu lates the release of ni tric ox ide, which re laxes vas cu lar smooth mus cle, pro duc ing vaso dila ta tion.…”

Section: Discussionmentioning

confidence: 99%

Who Develops Severe or Fatal Adverse Drug Reactions to Selective Serotonin Reuptake Inhibitors?

Dalfen

Stewart

2001

Can J Psychiatry

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SSRIs are relatively safe when their widespread use is compared with the prevalence of ADRs. SSRIs may, however, be associated with ADRs, and even death, following intentional overdose or when taken with 2 or more other drugs or alcohol (particularly another drug metabolized by CYP-450). Physicians prescribing SSRIs need to consider drug-drug interactions and carefully monitor patients with severe affective disorders, comorbid medical conditions (especially cardiovascular disease), alcohol abuse, or a history of overdosing.

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“…There are reports of accidental overdose in children leading to serotonin-syndrome-like reactions (105,175). There is a report of unstable angina apparently precipitated by sertraline (228), and two reports of sudden chest pain (16,101), although the treatment with sertraline does not appear to be associated with electrocardiographic changes (70). Although its safety in patients with coronary artery disease remains to be established, the SSRIs are generally considered safer than TCAs (213), and recent data suggest that sertraline is well tolerated and effective in depressed patients following myocardial infarction (210).…”

Section: Safety Profilementioning

confidence: 99%

The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders

2001

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The naphthylamine derivative sertraline is a potent and selective inhibitor of serotonin reuptake into presynaptic terminals. Sertraline has a linear pharmacokinetic profile and a half-life of about 26 h. Its major metabolite, desmethylsertraline does not appear to inhibit serotonin reuptake. Sertraline mildly inhibits the CYP2D6 isoform of the cytochrome P450 system but has little effect on CYP1A2, CYP3A3/4, CYP2C9, or CYP2C19. It is, however, highly protein bound and may alter blood levels of other highly protein bound agents. Sertraline is a widely used serotonin reuptake inhibitor that has been shown to have both antidepressant and antianxiety effects. Many clinical trials have demonstrated its efficacy in depression compared with both placebo and other antidepressant drugs. Its efficacy has also been demonstrated in randomized, controlled trials of patients with obsessive-compulsive disorder, panic disorder, social phobia, and premenstrual dysphoric disorder. In short-term, open-label studies it has appeared efficacious and tolerable in children and adolescents and in the elderly, and data are positive for its use in pregnant or lactating women. Typical side effects include gastrointestinal and central nervous system effects as well as treatment-emergent sexual dysfunction; withdrawal reactions may be associated with abrupt discontinuation of the agent. The safety profile of sertraline in overdose is very favorable. Sertraline's efficacy for both mood and anxiety disorders, relatively weak effect on the cytochrome P450 system, and tolerability profile and safety in overdose are factors that contribute to make it a first-line agent for treatment in both primary and tertiary care settings.

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Sudden chest pain with sertraline

Cited by 8 publications

References 1 publication

Fatal Intoxication With a Selective Serotonin Reuptake Inhibitor, Lorazepam, and Codeine

Fatal Intoxication With a Selective Serotonin Reuptake Inhibitor, Lorazepam, and Codeine

Who Develops Severe or Fatal Adverse Drug Reactions to Selective Serotonin Reuptake Inhibitors?

The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders

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