Manuela Stoicescu
University of Oradea, Romania
Title: The risk of antidepressants drugs in patients with prolonged congenital QT syndrome
Biography
Biography: Manuela Stoicescu
Abstract
Objectives: The main important objective of this presentation is to attract attention that the therapy with antidepressant drugs is not inoffensive. In the last period there was an abuse of therapy with antidepressant drugs with or without serious justification. Many young women used these pills after diagnosis of depression. This abuse must to be stopped because of dangerous sides effects.
Material & Methods: Present the situation of a woman patient 40 years old, non-smoker, without coffee or alcohol consume, with a good life style, which started the therapy with tricyclic antidepressant drug–amitriptyline,10 mg orally 3 times daily with four month ago, after her husband deeds in a car accident and she was diagnosis with depression. After that, she came at the consultation for a crisis of palpitations. The EKG showed torsades de pointes and needs antiarrhythmic i.v. therapy to revue in sinus rhythm. When the patient become in sinus rhythm appear evident on EKG the QT interval very long so a prolonged QT interval. This could be a side effect after amitriptyline administration, or the patient can have had an unknown prolonged congenital QT interval and the antidepressant drug prolong more than that the QT interval and this degenerate and develop torsades de pointes, very risky because can induce ventricular fibrillation and sudden death. Of course the therapy was stopped.
Results & Discussions: The antidepressant drug - amitriptyline is contraindicating at the patients with congenital prolog QT syndrome. It is dangerous to start this therapy without one minimum EKG before, to exclude this congenital prolog QT syndrome unknown, because is asymptomatic. Also, at the categories of patients with normal EKG previously, can develop side effects prolog QT syndrome after amitriptyline, but if the congenital prolong QT syndrome is present, the risk for torsades de points are higher.
Conclusions: The administration of antidepressant drugs without an EKG before started this therapy, is dangerous because these categories of drugs especial amitriptyline develop side effects prolong QT syndrome and if a patient had an unknown congenital QT long syndrome this side effects prolong more QT interval and can degenerate in torsades de pointes, ventricular fibrillation, cardiac arrest and sudden death. The patients must to be attention about this dangerous risk.