Trazodone-Aggravated Ventricular Arrhythmias

Janowsky, David S.; Curtis, Guy P.; Zisook, Sid; Kuhn, Katja E.; K, Resovsky; Winter, M.

doi:10.1097/00004714-198312000-00010

Cited by 29 publications

(5 citation statements)

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“…Sua eficácia, entretanto, não foi comprovada em estudos com amostras clínicas significativas. Além disso, esse agente costuma causar efeitos colaterais importantes, incluindo hipotensão ortostática, além de riscos cardiovasculares (Janowsky et al;1983;Pansini et al;.…”

Section: Benzodiazepínicos E Antidepressivosunclassified

Insônia na menopausa e perimenopausa: características clínicas e opções terapêuticas

Soares¹

2006

Rev. psiquiatr. clín.

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Revisão de LiteraturaInsônia na menopausa e perimenopausa -características clínicas e opções terapêuticas CLAUDIO N. SOARES 1 ResumoTranstornos do sono e insônia são mais freqüentemente observados entre as mulheres do que entre os homens durante a vida adulta. Entre outros fatores, especula-se que alta comorbidade psiquiátrica para transtornos afetivos e ansiosos entre as mulheres contribua para maior ocorrên-cia de insônia. Além disso, períodos de intensa variabilidade hormonal (por exemplo, gestação e puerpério, perimenopausa) parecem estar relacionados com maior incidência de insônia e de transtornos respiratórios do sono entre as mulheres. Estudos populacionais sugerem que a transição menopausal constitue um período de maior risco para o desenvolvimento de sintomas depressivos, vasomotores e de insônia. Este artigo examina os fatores clínicos e hormonais que contribuem para a ocorrência de insônia durante a peri e a pós-menopausa. Opções terapêuticas são discutidas, incluindo técnicas cognitivo-comportamentais, tratamentos hormonais, agentes hipnótico-sedativos, antidepressivos e tratamentos de medicina alternativa.Palavras-chave: Insônia, mulheres, menopausa, hipnóticos, estrógenos. AbstractSleep disturbances and insomnia are more commonly observed in adult females than in adult males. It has been speculated that comorbid depression and anxiety among females may contribute to a higher incidence of insomnia. In addition, periods of intense hormonal variability (e.g.; pregnancy/postpartum, menopause transition) appear to be associated with higher incidence of sleep disturbances in females. Epidemiologic studies suggest that the menopausal transition constitutes a period of heightened risk for the occurrence of depressive symptoms and vasomotor complaints, as well as insomnia. This article reviews the clinical and hormone factors that may play a role for the development of insomnia during the menopausal transition and postmenopause. Treatment options are critically reviewed, including cognitive-behavioral techniques, hormonal treatments, hypnotics, antidepressants, and complimentary/alternative medicine.

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Section: Benzodiazepínicos E Antidepressivosunclassified

Insônia na menopausa e perimenopausa: características clínicas e opções terapêuticas

Soares¹

2006

Rev. psiquiatr. clín.

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“…At therapeutic doses, prolongation of the QT interval produced by most of the antipsychotics and tricyclic and tetracyclic antidepressants is partly due to the widening of the QRS complex that results from their Na + channel blocking properties, as well as to the blockade of several K + channels [83,84]. QT prolongation and TdP have been observed in psychiatric patients, as well as after accidental or suicidal overdosage with tricyclic and tetracyclic antidepressants [49,58,81,[85][86][87][88][89][90].…”

Section: • Vasodilatorsmentioning

confidence: 99%

Molecular Predictors of Drug-induced Prolongation of the QT Interval

Dilaveris

2005

CMCCHA

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One of the most common causes of drug withdrawal from the market is the prolongation of the QT interval associated with polymorphic ventricular tachycardia or torsade de pointes (TdP) that can degenerate into ventricular fibrillation and sudden cardiac death. Cardiac and non-cardiac drugs prolong the QT interval and cause TdP by blocking cardiac K+ channels in general, and selectively blocking the rapidly activating delayed rectifier channel IKr. Co-assembly of HERG (human-ether-a-go-go-related gene) alpha-subunits and MiRP1 (MinK-related peptide 1) beta-subunits recapitulate the behavior of native human IKr, and the majority of mutations of HERG and MiRP1 decrease the repolarizing current, delay ventricular repolarization and prolong the QT. Thus, drug-induced QT prolongation and TdP might represent an iatrogenic reproduction of the congenital long-QT syndrome (LQTS). Current evidence suggests that 5 to 10% of persons in whom TdP develops on exposure to QT-interval prolonging drugs harbor mutations associated with the LQTS and can therefore be viewed as having a subclinical form of the congenital syndrome. This clinical observation is entirely consistent with the concept of reduced repolarization reserve arising from a mutation in an ion-channel gene, which predisposes the carrier to drug-induced TdP. This review centers on the possible molecular mechanisms underlying drug-induced QT prolongation and TdP, the description of specific drugs and risk factors facilitating the development of TdP, and the recommendations for preventing and treating this potentially fatal arrhythmia.

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“…As a result, numerous short articles and letters to the editor have appeared that document patients ingesting trazodone who subse quently experienced cardiac problems. These include reports of atrial fibrillation and other arrhythmias, as well as evidence of conduction problems [35,[39][40][41][42][43][44][45]. There is also an interesting case report of an apparent complete heart block developing in an indi vidual after a single dose of trazodone [46].…”

Section: Safety' Profilementioning

confidence: 99%

United States Experience with Trazodone: A Literature Review

Schuckit¹

1987

Psychopathology

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This paper reviews clinically oriented manuscripts published over the last 5 years dealing with US experience with trazodone. Three major questions are addressed. First, there is ample documentation that trazodone is an effective antidepressant with results comparable to the tricyclic antidepressant agents in treating major depressive disorders. Second, trazodone offers significant safety advantages over other antidepressant drugs in overdose and has remarkably low levels of anticholinergic properties. Third, it is concluded that the unique structure of this drug and the balance between efficacy and side-effect profile combine to offer the clinician an interesting and potentially important treatment for depression.

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Trazodone-Aggravated Ventricular Arrhythmias

Cited by 29 publications

References 0 publications

Insônia na menopausa e perimenopausa: características clínicas e opções terapêuticas

Insônia na menopausa e perimenopausa: características clínicas e opções terapêuticas

Molecular Predictors of Drug-induced Prolongation of the QT Interval

United States Experience with Trazodone: A Literature Review

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