Unerwünschte kardiovaskuläre
Wirkungen von Psychopharmaka
Pathophysiologie und Risikominimierung
Katharina Wenzel-Seifert, Regensburg, Claus-Peter Ostermeier, Werneck, Nagia Ben Omar und Ekkehard Haen, Regensburg, für die Arbeitsgemeinschaft Arzneimittel therapie bei psychiatrischen Erkrankungen (AGATE e. V.) Literatur
21. Druteika D, Zed PJ. Cardiotoxicity following bupropion overdose. Ann Pharmacother 2002;36:1791–5. Epub 2002 Oct 26.
1. Agus ZS. Hypomagnesemia. J Am Soc Nephrol 1999;10:616–22.
22. Eap CB, Crettol S, Rougier JS, Schlapfer J, et al. Stereoselective block 2. Alvarez P, Pahissa J. QT alterations in psychopharmacology: proven can- of hERG channel by (S)-methadone and QT interval prolongation in didates and suspects. Curr Drug Saf 2010;5:97–104.
CYP2B6 slow metabolizers. Clin Pharmacol Ther 2007;81:719–28. Epub 3. Antzelevitch C. Ionic, molecular, and cellular bases of QT-interval pro- longation and torsade de pointes. Europace 2007;9(Suppl 4):iv4–15. 23. Eckhardt LL, Rajamani S, January CT. Protein trafficking abnormalities: a new mechanism in drug-induced long QT syndrome. Br J Pharmacol 4. Arizona CERT. QT Drug Lists by Risk Groups. dical-pros/drug-lists/drug-lists.cfm (Zugriff am 15.06.2013).
24. FDA. Information for Healthcare Professionals: Haloperidol (marketed 5. Arzneimittelkommission der Deutschen Ärzteschaft. Information über as Haldol, Haldol Decanoate and Haldol Lactate). FDA ALERT 9/2007. die Änderung der bisher empfohlenen Applikationswege von Haldol®- Janssen Injektionslösung. AkdÄ Drug Safety Mail 2010. http://www.
onforPatientsandProviders/DrugSafetyInformationforHeathcareProfessi- (Zugriff am onals/ucm085203.htm. (Zugriff am 15.06.2013).
25. FDA. FDA Drug Safety Communication: Abnormal heart rhythms asso- 6. Astrom-Lilja C, Odeberg JM, Ekman E, Hägg S. Drug-induced torsades de ciated with high doses of Celax® (citalopram hydrochloride). FDA Drug pointes: a review of the Swedish pharmacovigilance database. Pharma- Safety Communication 24.8.2011. coepidemiol Drug Saf 2008;17:587–92.
ucm269086.htm (Zugriff am 15.06.2013).
7. Azene EM, Xue T, Li RA. Molecular basis of the effect of potassium 26. FDA. Stimulant medications used in children with attention-deficit/hy- on heterologously expressed pacemaker (HCN) channels. J Physiol peractivity disorder – Communication about an ongoing review. FDA 2003;547:349–56. Epub 2003 Feb 04.
drug safety communications 12.12.2011. 8. Banov M, Tohen M, Friedberg J. High risk of eosinophilia in women trea- DrugSafety/ucm277770.htm. (Zugriff am 15.06.2013).
ted with cloza pine. J Clin Psychiatry 1995;54:466–9.
27. FDA. Safety review of medications used to treat attention-deficit/hyper- 9. Barak Y, Swartz M, Levy D, Weizman R. Age-related differences in the activity disorder (ADHD) in adults. FDA drug safety communications side effect profile of citalopram. Prog Neuropsychopharmacol Biol Psy- 12.12.2011. (Zu- chiatry 2003;27:545–8. Epub 2003 Apr 15.
10. Berkelhammer C, Bear R. A clinical approach to commen electrolyte 28. FDA Center for Drug Evaluation and Research. Approval package for Ce- problems: 4. Hypomagnesemia. Can Med Assoc J 1985;132:360–8.
lexa: Interdisciplinary Review Team for QT Studies Consultation: Tho- 11. Beyenburg S, Schonegger K. Severe bradycardia in a stroke patient rough QT Study Review. 12. August 2011. S. 77–104. http://www.access- caused by a single low dose of escitalopram. Eur Neurol 2007;57:50–1. ig1s016s017Rev.pdf [77–104] (Zugriff am 15.06.2013).
12. Bogdanov KY, Vinogradova TM, Lakatta EG. Sinoatrial nodal cell ryano- 29. Feinstein RE. Cardiovascular effects of novel antipsychotic medications. dine receptor and Na+-Ca2+ exchanger: molecular partners in pacemaker Heart Dis 2002;4:184–90. Epub 2002 May 25.
regulation. Circ Res 2001;88:1254–8. Epub 2001 Jun 23.
30. Florian J, Garnett CE, Nallani SC, Rappaport BA, et al. A modeling and 13. Butany J, Ahn E, Luk A. Drug-related cardiac pathology. J Clin Pathol simulation approach to characterize methadone QT prolongation using 2009;62:1074–84. Epub 2009 Dez 01.
pooled data from five clinical trials in MMT patients. Clin Pharmacol 14. Carnahan RM, Lund BC, Perry PJ, Pollock BG, et al. The anticholiner- Ther 2012;91:666–72. Epub 2012 Mar 02.
gic drug scale as a measure of drug-related anticholinergic burden: 31. Goodnick PJ, Jerry J, Parra F. Psychotropic drugs and the ECG: focus on associations with serum anticholinergic activity. J Clin Pharmacol the QTc interval. Experts Opin Pharmacother 2002;3:479–98.
32. Haas SJ, Hill R, Krum H, Liew D, et al. Clozapine-associated myocarditis: 15. Castro VM, Clements CC, Murphy SN, Gainer VS, et al. QT interval and a review of 116 cases of suspected myocarditis associated with the use of antidepressant use: a cross sectional study of electronic health records. clozapine in Australia during 1993–2003. Drug Saf 2007;30:47–57. Epub BMJ 2013;346:f288. DOI: 10.1136/bmj.f288. Epub 2013 Jan 31.
16. Chew ML, Mulsant BH, Pollock BG, Lehman ME, et al. Anticholinergic 33. Haddad P, Anderson I. Antipsychotic-related QTc prolongation, torsade activity of 107 medications commonly used by older adults. J Am Geriatr de pointes and sudden death. Drugs 2002;62:1649–71.
Soc 2008;56:1333–41. Epub 2008 May 31.
34. Haverkamp H, Deuschle M. Antipsychotikainduzierte QT-Verlängerung. 17. Cohn J, Kowey P, Whelton P, Prisant L. New guidelines for potassium replacement in clinical practice. A contemperary review by the national council on potassium in clinical practice. Arch Int Med 2000;160:2429–36.
18. Couderc JP, Xiaojuan X, Zareba W, Moss AJ. Assessment of the stability of the individual-based correction of QT interval for heart rate. Ann Nonin-vasive Electrocardiol 2005;10:25–34. Epub 2005 Jan 15.
19. Coulter D, Bate A, Mayboom R, Lindquist M, et al. Antipsychotic drugs Dr. med. Katharina Wenzel-Seifert, Nagia Ben Omar, Prof. Dr. med. Dr. rer. nat. Ekke-
and heart muscle disorder in international parmacovigilance: data min- hard Haen, Klinische Pharmakologie am Lehrstuhl mit Poli klinik für Psychiatrie und
Psychotherapie der Universität Regensburg, Universitätsstraße 84, 93053 Regensburg,
20. DePonti F, Poluzzi E, Montanaro N. Organising evidence on QT prolon- E-Mail: [email protected]
gation and occurrence of torsades de pointes with non-anti-arrhythmic Claus-Peter Ostermeier, Krankenhaus für Psych iatrie, Psychotherapie und Psychosomati-
drugs: a call for consensus. Eur J Clin Pharmacol 2001;57:185–209.
sche Medizin Schloss Werneck, Balthasar-Neumann-Platz 1, 97440 Werneck
Arzneimitteltherapie 31. Jahrgang · Heft 11 · 2013 *1
AMT Übersicht
35. Hiemke C, Bauman P, Bergemann N, Conca A, et al. AGNP-Konsensus- 60. Oka H, Yoshioka M, Onouchi K, Morita M, et al. Characteristics of ortho- Leitlinien für therapeutisches Drug-Monitoring in der Psych iatrie: Up- static hypotension in Parkinson’s disease. Brain 2007;130:2425–32.
date 2011. Psychopharmakotherapie 2012;19:91–122.
61. Oudit GY, Korley V, Backx PH, Dorian P. Lithium-induced sinus node 36. Hoffmann P, Warner B. Are hERG-channel inhibition and QT interval disease at therapeutic concentrations: linking lithium-induced block- prolongation all there is in drug-induced torsadogenesis? A review of ade of sodium channels to impaired pacemaker activity. Can J Cardiol emerging trends. J Pharmacol Toxicol Methods 2006;53:87–105. Epub 62. Ozeki Y, Fujii K, Kurimoto N, Yamada N, et al. QTc prolongation and an- 37. Howell C, Wilson AD, Waring WS. Cardio vas cular toxicity due to ven- tipsychotic medications in a sample of 1,017 patients with schizophre- lafaxine poison ing in adults: a review of 235 consecutive cases. B J Clin nia. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:401–5.
Pharmacol 2007;64:192–7. Epub 2007 Feb 15.
63. Pacher P, Kecskemeti V. Cardiovascular side effects of new antidepres- 38. Hsu C, Liu P, Chen J, Yeh T, et al. Electrocardiographic abnormalities as sants and antipsychotics: New drugs, old concerns? Curr Pharm Des predictors for over-range lithium levels. Cardiology 2005;103:101–6.
39. Ide A, Kamijo Y. Intermittent complete atrio ventricular block after long 64. Peterson K, McDonagh MS, Fu R. Comparative benefits and harms of term low-dose carbamazepine therapy with a serum concentration less competing medications for adults with attention-deficit hyperactivity than the therapeutic level. Intern Med 2007;46:627–9. Epub 2007 May disorder: a systematic review and indirect comparison meta-analysis. Psychopharmacology 2008;197:1–11. Epub 2007 Nov 21.
40. Iqbal M, Rahman A, Husain Z, Mahmud S, et al. Clozapine: A clini- 65. Poluzzi E, Raschi E, Moretti U, De Ponti F. Drug-induced torsades de cal review of adverse effects and management. Ann Clin Psychiatry pointes: data min ing of the public version of the FDA Adverse Event Reporting System (AERS). Pharmacoepidemiol Drug Saf 2009;18:512–8.
41. Justo D, Prokhorov V, Heller K, Zeltser D. Torsade de pointes induced by 66. Priori SG, Aliot E, Blomstrom-Lundqvist C, Bossaert L, et al. Task Force psychotropic drugs and the prevalence of its risk factors. Acta Psychiat on Sudden Cardiac Death, European Society of Cardiology. Europace Scand 2005;111:171–6. Epub 2005 Feb 11.
42. Kandan SR, Saha M. Severe primary hypothyroidism presenting with 67. Rajamani S, Eckhardt LL, Valdivia CR, Klemens CA, et al. Drug-induced torsades de pointes. BMJ Case Rep 2012; DOI: 10.1136/bcr.12.2011.5306. long QT syndrome: hERG K+ channel block and disruption of protein traf- ficking by fluoxetine and norfluoxetine. Br J Pharmacol 2006;149:481–9. 43. Kiev A, Masco HL, Wenger TL, Johnston JA, et al. The cardiovascular ef- fects of bupropion and nortriptyline in depressed outpatients. Ann Clin 68. Rastergar A, Soleimani M. Hypokal aemia and hyperkalaemia. Postgrad Psychiatry 1994;6:107–15. Epub 1994 Jun 01.
44. Killian J, Kerr R, Lawrence C, Celermajer D. Myocarditis and cardiomyo- 69. Reddy S, Hui D, El Osta B, de la Cruz M, et al. The effect of oral metha- pathy with clozapine. Lancet 1999;354:1841–5.
done on the QTc interval in advanced cancer patients: a prospective 45. Kleinfeld M, Borra S, Gavani S, Corcoran A. Hypokalemia: Are elderly pilot study. J Palliat Med 2010;13:33–8.
females more vulnerable? J Natl Med Assoc 1993;85:861–4.
70. Roesch-Ely D, Van Einsiedel R, Kathofer S, Schwaninger M, et al. Myocar- 46. Krantz MJ, Lewkowiez L, Hays H, Woodroffe MA, et al. Torsade de ditis with quetiapine. Am J Psychiatry 2002;159:1607–8.
pointes associated with very-high-dose methadone. Ann Intern Med 71. Roose SP, Glassman AH, Giardina EG, Walsh BT, et al. Tricyclic antide- pressants in depressed patients with cardiac conduction dis ease. Arch 47. Leung JYT, Barra AM, Procyshynb RM, Honerb WG, et al. Cardiovascular Gen Psychiatry 1987;44:273–5. Epub 1987 Mar 01.
side-effects of antipsychotic drugs: The role of the autonomic nervous 72. Roose SP, Dalack GW, Glassman AH, Woodring S, et al. Cardiovascular system. Pharmacol Ther 2012;135:113–22.
effects of bupropion in depressed patients with heart disease. Am J Psy- 48. Lilly Deutschland GmbH. Risiko eines Blutdruck- und Herzfrequenzan- chiatry 1991;148:512–6. Epub 1991 Apr 01.
stiegs. Rote-Hand-Brief zu Strattera® (Atomoxetin) 07.12.2011. www.
73. Sala M, Vicentini A, Brambilla P, Montomoli C, et al. QT interval pro- (Zu- longation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Ann Gen Psychiatry 2005;4:1. 49. Lockhart IA, Mitchell SA, Kelly S. Safety and tolerability of donepezil, rivastigmine and galantamine for patients with Alzheimer’s disease: 74. Schömig H, Ritz E, Stein G. Elektrolyt- und Wasserhaushalt. In: Berdel systematic review of the „real-world“ evidence. Dement Geriatr Cogn W, Böhm M, Classen M, Diehl V, et al. (Hrsg.). Innere Medizin. 5. Auflage. Disord 2009;28:389–403. Epub 2009 Nov 07.
München: Urban & Fischer, 2004: 1729–63.
50. Lundbeck GmbH. Zusammenhang von Escitalopram (Cipralex®) mit 75. Sharma ND, Rosman HS, Padhi ID, Tisdale JE. Torsades de pointes associ- dosisabhängiger QT-Intervall-Verlängerung. Rote-Hand-Brief zu Escitalo- ated with intravenous haloperidol in critically ill patients. Am J Cardiol pram (Cipralex®) 5. Oktober 2011. gilanz/risikoinfo/Archiv/2011/rhb-cipralex.html (Zugriff am 15.06.2013).
76. Shojaie M, Eshraghian A. Primary hypo thyroidism presenting with 51. Lundbeck GmbH. Zusammenhang von Cipramil® (Citalopramhydrobro- Torsades de pointes type tachycardia: a case report. Cases J 2008;1:298. mid /Citalopramhydrochlorid) mit dosisabhängiger QT-Intervallverlän- gerung. Rote-Hand-Brief zu Cipramil® (Citalopram). 31. Oktober 2011. 77. Siebrands CC, Schmitt N, Friederich P. Local anesthetic interaction with human ether-a-go-go-related gene (HERG) channels: role of aromatic cipramil.html (Zugriff am 15.06.2013).
amino acids Y652 and F656. Anesthesiology 2005;103:102–12. Epub 2005 52. Mackin P. Cardiac side effects of psychiatric drugs. Human Psychophar- 78. Spallone V, Ziegler D, Freeman R, Bernardi L, et al. Cardiovascular auto- 53. Mayet S, Gossop M, Lintzeris N, Markides V, et al. Methadone mainte- nomic neuropathy in diabetes: clinical impact, assessment, diagnosis, nance, QTc and torsade de pointes: who needs an electrocardiogram and management. Diabetes Metab Res Rev 2011 Jun 23, doi: 10.1002/ and what is the prevalence of QTc prolongation? Drug Alcohol Rev 2011;30:388–96. Epub 2011 Maerz 02.
79. Spigset O. Adverse reactions of selective serotonin reuptake inhibitors: 54. McKnight RF, Adida M, Budge K, Stockton S, et al. Lithium toxicity profi- reports from a spontaneous reporting system. Drug Saf 1999;20:277–87. le: a systematic review and meta-analysis. Lancet 2012;379:721–8. Epub 80. Stahl SM, Grady MM, Moret C, Briley M. SNRIs: their pharmacology, cli- 55. Merrill D, Dec G, Goff D. Adverse cardiac effects associated with clozapi- nical efficacy, and tolerability in comparison with other classes of anti- ne. J Clin Psychopharmacol 2005;25:32–41.
depressants. CNS Spectr 2005;10:732–47. Epub 2005 Sep 06.
56. Meyer-Massetti C, Cheng CM, Sharpe BA, Meier CR, et al. The FDA exten- 81. Stallvik M, Nordstrand B, Kristensen O, Bathen J, et al. Corrected QT in- ded warning for intravenous haloperidol and torsades de pointes: how terval during treatment with methadone and buprenorphine – relation should institutions respond? J Hosp Med 2010;5:E8–16. Epub 2010 Apr to doses and serum concentrations. Drug Alcohol Depend 2013;129:88– 57. Mitcheson JS. hERG potassium channels and the structural basis of drug- 82. Sterke CS, Ziere G, van Beeck EF, Looman CW, et al. Dose-response rela- induced arrhythmias. Chem Res Toxicol 2008;21:1005–10. Epub 2008 tionship between selective serotonin re-uptake inhibitors and injurious falls: a study in nursing home residents with dementia. B J Clin Pharma- 58. Novartis. Association of Clozaril (clozapine) with cardiovasculr toxicity. Dear Healthcare Professional Letter. 14.01.2002. http://www.canadien- 83. Stöllberger C, Huber JO, Finsterer J. Antipsychotic drugs and QT prolon- gation. Int Clin Psychopharmacology 2005;20:243–51.
84. Straus SM, Bleumink GS, Dieleman JP, van der Lei J, et al. Antipsychotics 59. Offerman SR, Alsop JA, Lee J, Holmes JF. Hospitalized lithium overdo- and the risk of sudden cardiac death. Arch Intern Med 2004;164:1293–7. se cases reported to the California Poison Control System. Clin Toxicol *2 Arzneimitteltherapie 31. Jahrgang · Heft 11 · 2013
Unerwünschte kardiovaskuläre Wirkungen von Psychopharmaka 85. Talati SN, Aslam AF, Vasavada B. Sinus node dysfunction in association with chronic lithium therapy: a case report and review of literature. Am J Ther 2009;16:274–8. Epub 2009 Apr 09.
86. Tank J, Schroeder C, Diedrich A, Szczech E, et al. Selective impairment in sympathetic vasomotor control with norepinephrine transporter in-hibition. Circulation 2003;107:2949–54. Epub 2003 Jun 11.
87. Thanacoody HK, Thomas SH. Tricyclic antidepressant poisoning: cardio- vascular toxicity. Toxicol Rev 2005;24:205–14. Epub 2006 Jan 05.
88. van Melick EJ, Wilting I, Meinders AE, Egberts TC. Prevalence and de- terminants of thyroid disorders in elderly patients with affective dis-orders: lithium and nonlithium patients. Am J Geriatric Psychiatry 2010;18:395–403. Epub 2010 Apr 30.
89. van Noord C, Straus S, Sturkenboom M, Hofman A, et al. Psychotropic drugs associated with corrected QT interval prolongation. J Clin Psycho-pharmacol 2009;29:9–15.
90. Vieweg WV, Wood MA, Fernandez A, Beatty-Brooks M, et al. Proarrhyth- mic risk with antipsychotic and antidepressant drugs: implications in the elderly. Drugs Aging 2009;26:997–1012. Epub 2009 Nov 26.
91. Warner B, Hoffmann P. Investigation of the potential of clozapine to cause torsade de pointes. Adverse Drug React Toxicol Rev 2002;21:189–203.
92. Weeke P, Jensen A, Folke F, Gislason GH, et al. Antidepressant use and risk of out-of-hospital cardiac arrest: a nationwide case-time-control study. Clin Pharmacol Ther 2012;92:72–9. Epub 2012 May 17.
93. Weiner I, Wingo C. Hypokalemia – Consequences, causes, and correc- tion. J Am Soc Nephrol 1997;8:179–88.
94. Wenzel-Seifert K, Haen E. Rote-Hand-Briefe zu Citalopram und Escitalo- pram. Psychopharmakotherapie 2012;19:19–21.
95. Wenzel-Seifert K, Haen E. Kardiovaskuläres Risiko bei medikamentöser ADHS-Behandlung. Psychopharmakotherapie 2013: im Druck.
96. Wenzel-Seifert K, Wittmann M, Haen E. Psychopharmakaassoziier- te QTc-Intervall-Verlängerung und Torsade de pointes. Dtsch Ärztebl 2011;108:687–93.
97. Wernicke J, Faries D, Girod D, Brown J, et al. Cardiovascular effects of atomoxetine in children, adolescents, and adults. Drug Saf 2003;26:729–40.
98. Wernicke J, Raskin J, Kajdasz DK, Wang F. An evaluation of the cardiova- scular safety profile of duloxetine: findings from 42 placebo-controlled studies. Drug Saf 2007;30:437–55.
Arzneimitteltherapie 31. Jahrgang · Heft 11 · 2013 *3


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Microscopic colitisChris J. J. Mulder1, Ivar M. Harkema2, Jos W. R. Meijer31 Department of Gastroenterology, Vrije Universiteit Medisch Centrum / Free University Medical Centre, Amsterdam, the Netherlands2 Department of Gastroenterology, Ziekenhuis Rijnstate / Rijnstate Hospital, Arnhem, the Netherlands3 Department of Pathology, Ziekenhuis Rijnstate / Rijnstate Hospital, Arnhem, the Netherlands

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