Psychiatria pre prax 4/2015

Rare adverse drug reactions in psychiatry: Serotonin syndrome and arrhythmia torsade de pointes

Arrhytmias associated to QT interval prolongation and serotonine syndrome, which are usually caused by pharmacodynamic interactions, both represent emerging thread. Long QT interval is associated with increased risk of torsade de pointes (TdP), which is a polymorphic ventricular tachycardia which can cause sudden death of the patient. TdP emerges at patients with congenital QT prolongation, or TdP appears when QT prolongation is acquired, which is caused by extrinsic factors, which are usually supported by some inborn dispositions. This paper summarizes current knowledge of the QT interval prolongation that is caused by drugs and suggests appropriate measures for practicing physicians. Serotonin syndrome is a rare potentially life-threatening condition, which is caused by drugs with serotoninergic aktivity. It is characterized by mental status changes, autonomic instability and neuromuscular hyperactivity. Patients with moderate and severe cases of serotonin toxicity require hospitalisation.

Keywords: drug-drug interactions, antipsychotic drugs, antidepresives, QT interval prolongation, serotonine syndrome.