An acute ischaemic event associated with the use of venlafaxine: a case report and proposed pathophysiological mechanisms

Venlafaxine, a structurally novel antidepressant, belongs to a new generati on of antidepressants-the serotonin/noradrenaline reuptake inhibitors. In c linical trials, venlafaxine was found safe and effective in most patients. However, significant changes in vital signs (hyper- and hypotension) and ca rdiac conduction abnormalities were observed in a few patients, notably in elderly patients. We present a case of an elderly woman with a pre-existing history of ischaemic heart disease, who was treated with venlafaxine, and developed acute myocardial ischaemia within the first week of treatment. Th is is the first report of a possible association between an acute cardiovas cular event and venlafaxine. The association of venlafaxine treatment with ischaemic events could be explained by its unique pharmacological and haemo dynamic properties.