Reactions 924 - 19 Oct 2002

Desipramine

Brugada syndrome in an elderly patient: case reportA 77-year-old woman developed Brugada syndrome while

receiving desipramine for the treatment of bipolar disorder.The woman had been hospitalised for evaluation, during

which an ECG was found to be significantly different from abaseline ECG recorded approximately 1 month earlier, 2 daysbefore her desipramine dose had been increased to 100mg/day [duration of treatment not stated]. Her lithium dosehad also been increased at this time, and her concomitantmedication included enalapril, atenolol, furosemide, warfarin,thyroxine, rosiglitazone and metformin. Examination revealeda regular HR of 60 beats/min and a BP of 115/51mm Hg. Herbaseline ECG had shown right ventricular conduction delayand, following the increase in her desipramine dose, this wasstill present. However, her ECG abnormalities at this timewere a QRS duration of 0.11s, downsloping ST-segmentelevation and inverted T-waves in leads V1-V3, and wereconsidered consistent with Brugada waves.

Lithium and desipramine were discontinued and the womanwas discharged from hospital receiving valproate semisodium[divalproex sodium]. A follow-up ECG 2 months later showedpersistent right ventricular conduction delay without Brugadawaves.Babaliaros VC, et al. Tricyclic antidepressants and the Brugada syndrome: anexample of Brugada waves appearing after the administration of desipramine.Clinical Cardiology 25: 395-398, Aug 2002 - USA 800915506

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Reactions 19 Oct 2002 No. 9240114-9954/10/0924-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved