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An acute ischaemic event associated with the use of venlafaxine: a case report and proposed pathophysiological mechanisms

Abarbanel Mental Health Centre; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel

Y. Rosen

Bat-Yam, Rabin Medical Centre-Beilinson Campus, Petah-Tikva; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel

B. Rosen

Edith Wolfson Medical Centre, Holon; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel

Venlafaxine, a structurally novel antidepressant, belongs to a new generation of antidepressants the serotonin/noradrenaline reuptake inhibitors. In clinical trials, venlafaxine was found safe and effective in most patients. However, significant changes in vital signs (hyperand hypotension) and cardiac conduction abnormalities were observed in a few patients, notably in elderly patients. We present a case of an elderly woman with a pre-existing history of ischaemic heart disease, who was treated with venlafaxine, and developed acute myocardial ischaemia within the first week of treatment. This is the first report of a possible association between an acute cardiovascular event and venlafaxine. The association of venlafaxine treatment with ischaemic events could be explained by its unique pharmacological and haemodynamic properties.

Key Words: cardiotoxicity • serotonin/noradrenaline reuptake inhibitors • venlafaxine

Journal of Psychopharmacology, Vol. 13, No. 2, 193-195 (1999)
DOI: 10.1177/026988119901300212


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