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Psychotropic treatment in patients with arrhythmia: About a case

Published online by Cambridge University Press:  13 August 2021

M. Suárez-Gómez*
Affiliation:
Psychiatry, Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal
S.S. Sánchez Rus
Affiliation:
Jaén, Complejo Hospitalario Jaén, Jaén, Spain
*
*Corresponding author.

Abstract

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Introduction

It is knowed the relationship between psychological problems and cardiovascular disease. Pychological alterations can cause cardiovascular diseases, and a cardiovascular event can trigger psychological alterations.

Objectives

The aim was to present a clinical case about a young man with cardiovascular alterations and depressive symptoms and to analyze the role played by cardiovascular drugs, psychoactive drugs, and their interactions.

Methods

We present the clinical case and search the relation between cardiovascular disease and depressive symptoms and treatment at scientific literature of last five years.

Results

A 38-year-old man comes to the emergency room with symptoms of palpitations, fatigue and shortness of breath for 2 weeks. An electrocardiogram is performed showing premature ventricular beats. The patient reports that he is sadder recently due to the loss of work, for which he is prescribed sertraline 50 mg daily and is referred to cardiology. No medical history or consumption of alcohol, tobacco or other toxins. The cardiologist requests ergometry, echocardiography, and Holter monitoring, resulting in all normal tests, with no evidence of ischemia. Bisoprolol 2.5 mg daily is prescribed and sertraline 50 mg daily is maintained. After two months, the patient reports feeling better in spirit. The control electrocardiogram is normal and the patient reports disappearance of palpitations. You are referred to your family doctor.

Conclusions

Elevation of cortisol, platelet hyperactivity, and alteration in heart rate variability were found in depressives. The SSRIs would be the ones of choice. Dual serotonin and noraderaline reuptake inhibitors should be avoided. Other atypical drugs such as bupropion or trazodone should be considered.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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