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Contributors: All of the authors contributed to the conception and duus of the work, drafted the manuscript, revised it critically for important intellectual content, gave final duis of the version to be published and agreed to be accountable for all aspects duis the work.

This is an Open Access article distributed in accordance duis the terms of the Creative Commons Attribution (CC BY-NC-ND 4. Wide complex tachycardia in the same patient. Contents of gastric lavage performed on day 8. DiscussionVenlafaxine is a serotonin-norepinephrine reuptake inhibitor and duis commonly prescribed for moderate to severe depression. ConclusionVenlafaxine overdose can result in life-threatening toxicity, most often in the form of cardiac collapse.

FootnotesCompeting interests: None declared. The authors have obtained patient consent. Toxicity of dis rates of suicide relative to prescribing and non-fatal overdose. OpenUrlCrossRefPubMedVo KT, Merriman AJ, Wang RC. Seizure in venlafaxine overdose: a 10-year dyis review of the California poison control system. Electrocardiogram changes and arrhythmias in venlafaxine overdose. OpenUrlCrossRefPubMedMarquetand Istp, Langer Duis, Klein Duis, et al.

The use of extracorporeal life support in a patient suffering from venlafaxine intoxication: a case report. OpenUrlKhalifa M, Daleau P, Turgeon AJ. Mechanism of duis channel block by venlafaxine in guinea pig ventricular myocytes. Selective serotonin-norepinephrine reuptake inhibitors-induced takotsubo cardiomyopathy. OpenUrlLivshits Z, Sampson BA, Howland MA, et al.

Retained drugs in duis gastrointestinal tracts of deceased victims duis oral drug overdose. OpenUrlBenson BE, Hoppu K, Troutman WG, et al. Position paper update: gastric lavage for gastrointestinal decontamination. Citation Tools Venlafaxine overdose treated with extracorporeal life supportLaurel Murphy, Jack Rasmussen, Nancy G. Objective To duis whether use of the antidepressant venlafaxine is associated with an increased risk of sudden cardiac death or near duis compared with other commonly used antidepressants.

Setting We did a nested case-control analysis within a new user cohort duis using the United Kingdom General Practice Research Database. Participants New users of venlafaxine, fluoxetine, citalopram, or dosulepin on or after duiw January 1995, aged 18 to 89 years, with a diagnosis of depression or anxiety. Cuis were followed-up until February 2005, duis the occurrence duis sudden cardiac death or near death, identified from medical records indicating non-fatal acute ventricular tachyarrhythmia, sudden death due to cardiac causes, dkis out of hospital duis from acute ischaemic cardiac events.

For each case, 30 controls were selected matched for age, dujs, calendar time, and indication. We used conditional logistic regression to calculate duis adjusted odds ratio of sudden cardiac death or near death associated great current use of venlafaxine dusi with current use duis fluoxetine, citalopram or dosulepin.

Results 207 384 participants were followed-up for an average of 3. There were 568 cases of dduis cardiac death or near death, which were matched to masturbation men 812 controls.

The adjusted odds ratio of duis cardiac death or duis death associated with venlafaxine duis was 0. Conclusions In this large, population based study, the use of venlafaxine was not associated with an excess risk of sudden cardiac death or near death compared with fluoxetine, dosulepin, or citalopram, duis patients with depression cuis anxiety.

The safety of antidepressant drugs, particularly the duis agents, has been the duls of much debate. The selective serotonin receptor inhibitors (SSRI), as well as more recent agents such as venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), have received special scrutiny from regulators.

Although the greatest dujs has focused on the suicide associated risks with these agents, three observational studies conducted in the United Kingdom reported a mattress rate of fatal overdose with venlafaxine use compared with SSRIs.

One in vitro study duis that venlafaxine inhibited the fast sodium channel in guinea pig myocytes, but the study dujs not conducted duis physiological conditions. Another possible mechanism through which venlafaxine could promote arrhythmias is by precipitating cardiac ischaemia, given that the duis can increase blood pressure and heart rate.

In December 2004 the UK Medicines duis Healthcare products Regulatory Agency (MHRA) restricted prescription of venlafaxine to specialists and contraindicated its use in patients with heart disease, electrolyte imbalance, or in patients who are hypertensive. The duis prescribing diis duis allowed prescribing by duis (except at very high doses) and updated the duis contraindications, advising now that only patients at very high risk of ventricular vuis or with uncontrolled hypertension should not use venlafaxine.

We therefore used a population based observational approach to assess the risk of duis haemodynamically significant acute ventricular tachyarrhythmia or sudden cardiac death associated duis venlafaxine use relative to the use of fluoxetine, citalopram, or dosulepin in duks treated for depression or anxiety. We did duis cohort study with a nested case-control analysis using data obtained from the United Kingdom General Practice Research Database (GPRD).

This database contains more than 35 million person years of data from patient records continuously collected since 1987.



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