Alexandrino-Silva Clóvis, Nadalini Mauá Fernando Henrique, de Andrade Arthur Guerra, de Toledo Ferraz Alves Tânia Corrêa
Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.
J Psychopharmacol. 2008 Mar;22(2):214-6. doi: 10.1177/0269881107076403. Epub 2008 Jan 21.
Although venlafaxine is usually associated with modest increases in blood pressure and not so often clinical hypertension, there are a few reported cases of hypotension related to overdoses of this specific antidepressant. The case study of a young female patient with a history of Major Depressive Disorder who initiated treatment with venlafaxine 75 mg/day and developed hypotension when the dosage was titrated up to 225 mg/day is described. The patient did not present comorbid diseases nor use other medication. A temporal association and a dose-dependent relationship between the hypotension and the use of venlafaxine is shown. To the best of the knowledge of the authors,this is the first case report that specifically associates regular doses of venlafaxine with the presence of hypotension. A pathophysiological mechanism is proposed, involving the participation of presynaptic alpha2-adrenergic receptors and the presence of a possible genetic polymorphism of cytochrome P4502D6, which is associated with lower drug metabolization, to explain the relationship between venlafaxine in regular dosage and development of hypotension.
尽管文拉法辛通常与血压适度升高相关，而较少引起临床高血压，但仍有少数关于该特定抗抑郁药过量导致低血压的报道病例。本文描述了一名患有重度抑郁症的年轻女性患者的病例研究，该患者开始服用文拉法辛75毫克/天，当剂量增至225毫克/天时出现了低血压。该患者没有合并疾病，也未使用其他药物。研究显示了低血压与文拉法辛使用之间的时间关联和剂量依赖关系。据作者所知，这是第一例将常规剂量的文拉法辛与低血压存在明确关联的病例报告。文中提出了一种病理生理机制，涉及突触前α2-肾上腺素能受体的参与以及细胞色素P4502D6可能存在的基因多态性，这与较低的药物代谢有关，以此来解释常规剂量文拉法辛与低血压发生之间的关系。
