AP-HP Avicenne Hospital, Department of Cardiology, Université Paris 13, UFR SMBH, 125 Route de Stalingrad, 93009 Bobigny Cedex, France.
Am J Emerg Med. 2010 Feb;28(2):256.e1-5. doi: 10.1016/j.ajem.2009.05.010.
We report a cardiac complication in a patient treated with regular doses of venlafaxine. A 49-year-old man with prior normal cardiac function and stable chronic hepatitis C was treated for a major depressive disorder with usual doses of venlafaxine during an 8-month period until the occurrence of a cardiogenic shock in a context of dilated cardiomyopathy. Three months after withdrawal of the drug, the left ventricular ejection fraction returned to normal values. Cardiomyopathy is a rare complication with high doses of venlafaxine that was not previously reported in patients free of prior cardiac disease and cardiomyopathy and treated with usual doses (initially 150 mg daily; after 3 months, 75 mg daily). An objective assessment revealed that venlafaxine was probably implied in the subsequent development of cardiomyopathy when considering the Naranjo Probability Scale. Physicians who usually prescribe venlafaxine have to be briefed on such potential cardiac adverse effects even with usual doses.
我们报告了一例接受文拉法辛常规剂量治疗的患者出现心脏并发症。一名 49 岁男性，既往心功能正常，慢性丙型肝炎稳定，在 8 个月的时间内接受常规剂量文拉法辛治疗重度抑郁症，直至扩张型心肌病发生心源性休克。停药 3 个月后，左心室射血分数恢复正常。在既往无心脏病和心肌病病史的患者中，文拉法辛的高剂量使用会导致心肌病，这是一种罕见的并发症，且通常剂量（最初每天 150 毫克；3 个月后每天 75 毫克）下此前尚未报道过。客观评估显示，根据 Naranjo 概率量表，文拉法辛可能与随后发生的心肌病有关。即使使用常规剂量，通常开处方文拉法辛的医生也必须了解这种潜在的心脏不良反应。
