Unexpected deaths in depressed medical inpatients treated with fluoxetine
Depression in the medically ill is underdiagnosed and undertreated. Fluoxetine would appear promising in this population because of its efficacy and benign side effect profile, but it has not been systematically studied in the medically ill. The authors report the cases of three seriously medically...
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Published in | The journal of clinical psychiatry Vol. 52; no. 9; p. 377 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
United States
01.09.1991
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Abstract | Depression in the medically ill is underdiagnosed and undertreated. Fluoxetine would appear promising in this population because of its efficacy and benign side effect profile, but it has not been systematically studied in the medically ill.
The authors report the cases of three seriously medically ill patients, seen in psychiatric consultation while patients on a general medical service, who were treated with fluoxetine for depression. Each was an elderly white female with pulmonary disease and atrial arrhythmias, including atrial fibrillation, and each was prescribed diuretics, nitrates, and other cardiac and/or pulmonary agents.
Each patient died within 10 days of beginning fluoxetine treatment, from unexplained causes.
The authors hypothesize that direct cardiac effects mediated by fluoxetine, or other factors, may have been contributory. The effects of fluoxetine on electrolytes, fluoxetine's possible effects on drug levels, and serotonin's effect on the pulmonary system are examined. Other antidepressant agents should be considered in this particular population until further data are available. |
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AbstractList | Depression in the medically ill is underdiagnosed and undertreated. Fluoxetine would appear promising in this population because of its efficacy and benign side effect profile, but it has not been systematically studied in the medically ill.
The authors report the cases of three seriously medically ill patients, seen in psychiatric consultation while patients on a general medical service, who were treated with fluoxetine for depression. Each was an elderly white female with pulmonary disease and atrial arrhythmias, including atrial fibrillation, and each was prescribed diuretics, nitrates, and other cardiac and/or pulmonary agents.
Each patient died within 10 days of beginning fluoxetine treatment, from unexplained causes.
The authors hypothesize that direct cardiac effects mediated by fluoxetine, or other factors, may have been contributory. The effects of fluoxetine on electrolytes, fluoxetine's possible effects on drug levels, and serotonin's effect on the pulmonary system are examined. Other antidepressant agents should be considered in this particular population until further data are available. |
Author | Spier, S A Frontera, M A |
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References | 8444826 - J Clin Psychiatry. 1993 Feb;54(2):71-2 |
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SubjectTerms | Aged Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - mortality Death, Sudden - etiology Depressive Disorder - complications Depressive Disorder - drug therapy Depressive Disorder - mortality Female Fluoxetine - adverse effects Fluoxetine - therapeutic use Fluoxetine - toxicity Humans Inpatients Lung Diseases - complications Lung Diseases - mortality Middle Aged Referral and Consultation |
Title | Unexpected deaths in depressed medical inpatients treated with fluoxetine |
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