Drug-induced panic attacks: Analysis of cases registered in the French pharmacovigilance database

Abadie, Delphine; Essilini, Anaïs; Fulda, Virginie; Gouraud, Aurore; Yéléhé‐Okouma, Mélissa; Micallef, Joëlle; Montastruc, François

doi:10.1016/j.jpsychires.2017.02.008

Cited by 22 publications

(22 citation statements)

References 45 publications

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“…Tremor and hyperhidrosis are commonly associated with serotonin syndrome and are in accordance with symptoms on the Hunter Toxicity Criteria Decision Rules and the Sternbach Criteria . Additionally, drug interactions are frequently reported in serotonin syndrome cases; this finding agrees with a previous study performed with the French pharmacovigilance database that examined serotonin syndrome cases and found drug–drug interactions primarily responsible for a large proportion of cases …”

Section: Resultssupporting

confidence: 89%

Association Between Serotonin Syndrome and Second‐Generation Antipsychotics via Pharmacological Target‐Adverse Event Analysis

Racz

Soldatos²,

Jackson³

et al. 2018

Clinical Translational Sci

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Case reports suggest an association between second‐generation antipsychotics (SGAs) and serotonin syndrome (SS). The US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) was analyzed to generate hypotheses about how SGAs may interact with pharmacological targets associated with SS. FAERS was integrated with additional sources to link information about adverse events with drugs and targets. Using Proportional Reporting Ratios, we identified signals that were further investigated with the literature to evaluate mechanistic hypotheses formed from the integrated FAERS data. Analysis revealed common pharmacological targets perturbed in both SGA and SS cases, indicating that SGAs may induce SS. The literature also supported 5‐HT2A antagonism and 5‐HT1A agonism as common mechanisms that may explain the SGA‐SS association. Additionally, integrated FAERS data mining and case studies suggest that interactions between SGAs and other serotonergic agents may increase the risk for SS. Computational analysis can provide additional insights into the mechanisms underlying the relationship between SGAs and SS.

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Section: Resultssupporting

confidence: 89%

Association Between Serotonin Syndrome and Second‐Generation Antipsychotics via Pharmacological Target‐Adverse Event Analysis

Racz

Soldatos²,

Jackson³

et al. 2018

Clinical Translational Sci

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“…As regards the outcome data in this work, it revealed higher percentage of cases with GCS ≤10, QRS ≥100 msec, QTc ≥440 msec and ICU admission, as well as longer ICU and hospital stay time among the amitriptyline compared to fluoxetine groups of patients and a higher incidence of serotonin toxicity among fluoxetine compared to amitriptyline groups of patients. This is in accordance with Whyte et al (2003) and Abadie et al (2015) who believed that TCAs overdoses are much more likely to be with lower GCS and consequently require ICU admission, and much less likely to have serotonin toxicity than SSRIs. While, SSRIs overdoses were less likely to cause tachycardia, hypotension, and prolongation of the QRS and QTc than TCAs.…”

Section: Discussionsupporting

confidence: 90%

Comparative Study of the Acute Toxicity of Fluoxetine Versus Amitriptyline and the Predictive Factors for Their Complications

Azab

Elawady

2016

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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The aim of this study is to compare acute toxicity of fluoxetine versus that of amitriptyline among patients admitted to the Poison Control Centre, Ain Shams University (PCC-ASU) and to investigate some predictive factors for the development of complications in such cases. METHODS: A prospective study was conducted in the PCC-ASU during the period between January 2013 and December 2015. The study included 31 patients ingested fluoxetine alone and 49 patients ingested amitriptyline alone. Parameters: Descriptive variables: (age, gender, amount taken, delay time and manner of poisoning). Clinical variables: Vital signs, mean QRS duration, corrected QT (QTc), cardiac arrhythmias ,level of consciousness (assessed by Glasgow coma scale (GCS), pupil size and reactivity, seizures and symptoms of serotonin toxicity. Laboratory variables: (Serum sodium, potassium, calcium and magnesium and blood glucose level).The outcome variables: percentage of cases with: cardiac arrhythmias, QRS ≥100, QTc ≥440, seizures, GCS ≤10, serotonin toxicity, ICU admission, length of stay in ICU, length of hospital stay and survival. RESULTS: there was highly significant increase of the age, amount of drug ingested, mean QRS, QTc, mydriasis and significant decrease in the mean GCS and serum sodium in amitriptyline group compared to fluoxetine group. A highly significant increase of percentage of tremors, clonus, hyper-reflexia and diaphoresis was observed in fluoxetine group. As regards outcome variables, there was insignificant difference in percentage of cases with seizures and survival between both groups. There was significant increase in percentage of cases with QRS ≥100, QTc ≥440, GCS ≤10, ICU admission, length of stay in ICU and hospital in amitriptyline group. There was a highly significant increase of cases with serotonin toxicity in fluoxetine group. The patients who developed seizures after acute amitriptyline toxicity, showed a highly significant increase in the amount of drug intake, QRS, QTc duration and length of hospital stay and highly significant decrease of mean GCS and serum sodium level compared with patients without seizures. By applying logistic regression analysis, QRS ≥100 and QTc≥440 interval and GCS ≤10 were identified as independent risk factors and QRS≥100 showed (sensitivity 97%, specificity 71%, PPV 67% and NPV 97%); QTc ≥440 interval showed (sensitivity 65%,specificity 64%, PPV55% and NPV 68%) and GCS ≤10 showed (sensitivity 86%, specificity 71%, PPV 60% and NPV 80%).The patients who developed seizure after acute fluoxetine toxicity showed a highly significant increase in the amount of drug intake, QTc duration, and percentage of cases with serotonin toxicity and length of hospital stay and highly significant decrease of mean GCS compared with patients without seizures. By applying logistic regression analysis, QTc≥440, GCS≤10, and serotonin toxicity were identified as independent risk factors. QTc interval ≥440 showed (sensitivity 62%, specificity 82%, PPV 55% and NPV 86%); GCS≤10 showed (sensitivity 72%, specif...

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“…Serotonin syndrome is rare except in cases of overdose, but it can also occur with combination use of multiple serotonergic medications (e.g., SSRIs, SNRIs, tramadol). 76 …”

Section: What Are Clinically Relevant Drug-drug Interactions?mentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

et al. 2016

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Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ''Pharmacological Treatments'' is the third of six sections of the 2016 guidelines. With little new information on older medications, treatment recommendations focus on second-generation antidepressants.Results: Evidence-informed responses are given for 21 questions under 4 broad categories: 1) principles of pharmacological management, including individualized assessment of patient and medication factors for antidepressant selection, regular and

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Drug-induced panic attacks: Analysis of cases registered in the French pharmacovigilance database

Cited by 22 publications

References 45 publications

Association Between Serotonin Syndrome and Second‐Generation Antipsychotics via Pharmacological Target‐Adverse Event Analysis

Association Between Serotonin Syndrome and Second‐Generation Antipsychotics via Pharmacological Target‐Adverse Event Analysis

Comparative Study of the Acute Toxicity of Fluoxetine Versus Amitriptyline and the Predictive Factors for Their Complications

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

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