Doxepin-Induced Torsade de Pointes Tachycardia
Authors: Peter Alter, Daniela Tontsch, Wolfram Grimm
Journal: Annals of Internal Medicine (2001)

Letters4 September 2001Doxepin-Induced Torsade de Pointes TachycardiaPeter Alter, MD, Daniela Tontsch, MD, and Wolfram Grimm, MDPeter Alter, MDPhilipps-University Marburg; D-35033 Lahn, Germany (Alter), (Tontsch), (Grimm)Search for more papers by this author, Daniela Tontsch, MDPhilipps-University Marburg; D-35033 Lahn, Germany (Alter), (Tontsch), (Grimm)Search for more papers by this author, and Wolfram Grimm, MDPhilipps-University Marburg; D-35033 Lahn, Germany (Alter), (Tontsch), (Grimm)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The most frequent cause of the acquired long QT syndrome with torsade de pointes tachycardia is therapy with antiarrhythmic drugs, such as quinidine or sotalol. First-line therapy is discontinuation of therapy with the antiarrhythmic drug, application of magnesium, and transient pacing (1). Torsade de pointes tachycardia due to the long QT syndrome after treatment with tricyclic antidepressants has rarely been described (2-5).A 50-year-old woman had swallowed 6 g of doxepin (60 tablets) to commit suicide. After she was admitted to our intensive care unit, electrocardiography showed sinus tachycardia of 132 beats per minute with a rate-corrected ...References1. Banai S, Tzivoni D. Drug therapy for torsade de pointes. J Cardiovasc Electrophysiol. 1993;4:206-10. [PMID: 8269292] CrossrefMedlineGoogle Scholar2. Biggs J, Spiker D, Petit J, Ziegler V. Tricyclic antidepressant overdose: incidence of symptoms. JAMA. 1977;238:135-8. [PMID: 577282] CrossrefMedlineGoogle Scholar3. Hussey H. Editorial: Physostigmine: value in treatment of central toxic effects of anti-cholinergic drugs. JAMA. 1975;231:1066. [PMID: 1172797] CrossrefMedlineGoogle Scholar4. Buckley N, Dawson A, Whyte I, Henry D. Greater toxicity in overdose of dothiepin than of other tricyclic antidepressants. Lancet. 1994;343:159-62. [PMID: 7904010] CrossrefMedlineGoogle Scholar5. Veith R, Raskind M, Caldwell J, Barnes R, Gumbrecht G, Ritchie J. Cardiovascular effects of tricyclic antidepressants in depressed patients with chronic heart disease. N Engl J Med. 1982;306:954-9. [PMID: 7038497] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Philipps-University Marburg; D-35033 Lahn, Germany (Alter), (Tontsch), (Grimm) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCardiotoxicity of H1-antihistaminesMechanisms Underlying the Actions of Antidepressant and Antipsychotic Drugs That Cause Sudden Cardiac ArrestCurrent Phase II investigational therapies for insomniaValidation of a population-based method to assess drug-induced alterations in the QT interval: a self-controlled crossover studyDrugs for insomniaA Placebo- and Active-Controlled Assessment of 6- and 50-mg Oral Doxepin on Cardiac Repolarization in Healthy Volunteers: A Thorough QT EvaluationQTc Prolongation by Psychotropic Drugs and the Risk of Torsade de PointesKontinuierliche Herzfrequenzvariabilitäts-Analyse zur Beurteilung des kardialen autonomen Nervensystems nach Doxepin-IntoxikationSudden cardiac death secondary to antidepressant and antipsychotic drugsInhibition of the HERG potassium channel by the tricyclic antidepressant doxepinTricyclic and Other Cyclic AntidepressantsTorsade de pointes induced by psychotropic drugs and the prevalence of its risk factorsTricyclic Antidepressant PoisoningAdvances in H 1 -AntihistaminesTricyclic Antidepressants, QT Interval Prolongation, and Torsade de PointesStructural and Functional Basis for the Long QT Syndrome: Relevance to Veterinary PatientsDoxepin overdose 4 September 2001Volume 135, Issue 5Page: 384-385KeywordsArrhythmiaDrug therapyElectrocardiographyIntensive care unitsIntoxicationMagnesiumPacemakersSuicideTachycardiaTricyclic antidepressants ePublished: 4 September 2001 Issue Published: 4 September 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...