An extraordinary case of an organic psychosis during the treatment of a patient with a bipolar affective disorder.
Methods:
Clinical observation and further investigations including monitoring of serum levels (case report).
Results:
A significant interaction between venlafaxine and propafenone causes markedly increased serum levels of venlafaxine correlating with unexpected psychopathological changes.
Conclusions:
There is a potentially dangerous interaction between venlafaxine and propafenone. Serum levels of venlafaxine should be monitored if propafenone is added.
RudolphRLDerivanAT. The safety and tolerability of venlafaxine hydrochloride: Analysis of the clinical trials database. Journal of Clinical Psychopharmacology1996;16:54S–59S.
2.
KhanA. Overall safety profile of venlafaxine: Commentary. Journal of Clinical Psychopharmacology1996;16(3)(Suppl 2):59S–61S.
3.
Wyeth/Lederle. Fachinformation zu Trevilor [Pharmacological information concerning venlafaxine (Trevilor)]. Münister: Wyeth-Pharma, 1997.
4.
Bundesverband der Pharmazeutischen Industrie e. V. Rote Liste [List of all pharmaceutical products available in Germany]. Aulendorf: Editio Cantor: 318.
5.
HiiJTDuffHJBurgessED. Clinical pharmacokinetics of propafenone. Clinical Pharmacokinetics1991;21(1):1–10.
6.
KatzMR. Raised serum levels of desipramine with the antiarrhythmic propafenone. Journal of Clinical Psychiatry1991;52(10):432–433.
KlamerusKJMaloneyKRudolphRLSisenwineSFJuskoWJChiangST. Introduction of a composite parameter to the pharmacokinetics of venlafaxine and its active O-desmethyl metabolite. Journal of Clinical Pharmacology1992;32:716–724.
10.
HowellSRHusbandsGEMScatinaJASisenwineSF. Metabolic disposition of 14C-venlafaxine in mouse, rat, dog, rhesus monkey and man. Xenobiotica1993;23(4):349–359.
11.
BlytheDHackettLP. Cardiovascular and neurological toxicity of venlafaxine. Human and Experimental Toxicology1999;18(5):309–313.
12.
WoodlandCVerjeeZGiesbrechtEKorenGItoS. The digoxin-propafenone interaction: Characterization of a mechanism using renal tubular cell monolayers. Journal of Pharmacology and Experimental Therapeutics1997;283(1):39–45.
13.
BenkertOHippiusH. Kompendium der Psychiatrischen Pharmakotherapie [Handbook of psychiatric pharmacotherapy]. Berlin-Heidelberg: Springer, 1998:331.
14.
KlysnerRLarsenJKSorensenPHyllestedMPedersenBD. Toxic interaction of venlafaxine and isocarboxazide. Lancet1995;346(8985):1298–1299.
15.
PhillipsSDRingoP. Phenelzine and venlafaxine interaction. American Journal of Psychiatry1995;152 (9):1400–1401.
16.
KoleckiP. Isolated venlafaxine-induced serotonin syndrome. Journal of Emergency Medicine1997;15(4) 491–493.