cardiovascular-agents and Stress-Disorders--Post-Traumatic

The use of cardiovascular medications can have a variety of neuropsychiatric consequences. Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs. Depression has been associated with P3-blockers, methyldopa, and reserpine, but more recent syntheses of the data have suggested that these associations are much weaker than originally believed. Though low cholesterol levels have been associated with depression and suicide, lipid-lowering agents have not been associated with these adverse effects. Finally, cardiovascular medications may have beneficial neuropsychiatric consequences; for example, the use of clonidine in patients with attention deficit-hyperactivity disorder, the use of prazosin for patients with post-traumatic stress disorder; and the use of propranolol for performance anxiety and akathisia.

Topics: Adrenergic beta-Antagonists; Anxiety Disorders; Attention Deficit Disorder with Hyperactivity; Cardiovascular Agents; Cardiovascular Diseases; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Mental Disorders; Mood Disorders; Stress Disorders, Post-Traumatic

Topics: Adrenergic Agents; Animals; Anxiety; Cardiovascular Agents; Clonidine; Disease Models, Animal; Disease Susceptibility; Heart; Male; Myocardial Ischemia; Myocardium; Propranolol; Random Allocation; Rats, Sprague-Dawley; Stress Disorders, Post-Traumatic; Sympathetic Nervous System; Treatment Failure

Atrial fibrillation induced by electroconvulsive therapy (ECT) is rare, with only 3 reported cases. None of those cases involved either young healthy patients or right unilateral ECT. We report a 46-year-old healthy male observed to be in atrial fibrillation immediately after electrical induction of the 25th administration of right unilateral ECT. Diltiazem was administered, and he spontaneously cardioverted. After a negative cardiology workup, he safely resumed ECT. Atrial fibrillation was most likely triggered by autonomic imbalance due to the combination of electrical induction, seizure, and medication.

Topics: Anesthesia; Atrial Fibrillation; Cardiovascular Agents; Diltiazem; Electrocardiography; Electroconvulsive Therapy; Electroencephalography; Functional Laterality; Glycopyrrolate; Humans; Male; Middle Aged; Muscarinic Antagonists; Stress Disorders, Post-Traumatic; Suicidal Ideation; Tachycardia, Supraventricular