Cardiovascular toxicity due to venlafaxine poisoning in adults: a review of 235 consecutive cases
- 12 February 2007
- journal article
- case report
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 64 (2), 192-197
- https://doi.org/10.1111/j.1365-2125.2007.02849.x
Abstract
Venlafaxine may increase the risk of arrhythmia in certain patients. We sought to characterize the cardiovascular effects of venlafaxine overdose in adults. A retrospective casenote review of patients admitted to the Royal Infirmary of Edinburgh between January 2000 and June 2006. Haemodynamic and electrocardiographic data were examined in the whole group and a subset that ingested venlafaxine alone. Two hundred and thirty-five patients (65 men) with median (interquartile range) age 34 years (27-43 years) had ingested venlafaxine 1500 mg (919-2800 mg). Tachycardia (40.0%), high blood pressure (28.4%) and mydriasis (36.6%) were common. Corrected QT >450 ms occurred in seven men (11.1%) and 17 women (10.5%) and transient arrhythmia in three patients. There was a positive correlation between stated quantity of venlafaxine ingested and heart rate [rho = 0.195, 95% confidence interval (CI) 0.054, 0.328] and QTc (rho = 0.314, 95% CI 0.089, 0.509). Venlafaxine overdose is associated with sympathomimetic cardiovascular effects and prolonged QTc, irrespective of coingested drugs. These mechanisms might pose an increased risk of arrhythmia and require further exploration.Keywords
This publication has 25 references indexed in Scilit:
- Cardiovascular Changes Associated With Venlafaxine in the Treatment of Late-Life DepressionAmerican Journal of Geriatric Psychiatry, 2006
- QT interval prolongation associated with venlafaxine administrationInternational Journal of Cardiology, 2006
- Antidepressants: their effects on cardiac channels, QT prolongation and Torsade de Pointes.2006
- Pharmacokinetic–pharmacodynamic modelling of QT interval prolongation following citalopram overdosesBritish Journal of Clinical Pharmacology, 2005
- The yin and yang of cardiac autonomic control: Vago-sympathetic interactions revisitedBrain Research Reviews, 2005
- Tricyclic Antidepressant PoisoningToxicological Reviews, 2005
- Are we going to increase the use of antidepressants up to that of benzodiazepines?European Journal of Clinical Pharmacology, 2004
- Dynamic Beat-to-Beat Modeling of the QT-RR Interval Relationship: Analysis of QT Prolongation during Alterations of Autonomic State versus Human Ethera-go-go-Related Gene InhibitionThe Journal of pharmacology and experimental therapeutics, 2004
- Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressantsQJM: An International Journal of Medicine, 2003
- Comparison of the effects of venlafaxine, desipramine, and paroxetine on noradrenaline‐ and methoxamine‐evoked constriction of the dorsal hand veinBritish Journal of Clinical Pharmacology, 1999