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Nightmares and panic disorder associated with carvedilol overdose
Chiharu Maebara1, Hisakazu Ohtani, Hideyo Sugahara
1Department of Medico-Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan.
The Annals of Pharmacotherapy
|October 26, 2002
Summary
Improper use of carvedilol, an alpha/beta-blocker, can cause nightmares and sleep disorders by increasing nighttime beta(2)-adrenoceptor occupancy. Correcting the dosage resolved the patient's symptoms.
Area of Science:
- Pharmacology
- Neuroscience
Background:
- Carvedilol is an alpha/beta-blocker used to treat conditions like panic disorder.
- Adherence to prescribed medication regimens is crucial for patient safety and treatment efficacy.
Observation:
- A patient experiencing nightmares and panic attacks was found to be taking carvedilol improperly, doubling the prescribed dose.
- The patient's sleep disturbances resolved after adhering to the correct carvedilol dosage regimen.
Findings:
- Improper carvedilol dosing (5 mg twice daily in addition to the prescribed 10 mg once daily) significantly elevated nighttime beta(2)-adrenoceptor binding occupancy.
- This elevated occupancy at night mimicked the effect of propranolol, a different beta-blocker.
Implications:
- Incorrect medication use can lead to adverse effects, including sleep disturbances, due to altered receptor occupancy.
- Pharmacokinetic/pharmacodynamic modeling can help understand the relationship between drug dosage, receptor binding, and side effects.
- Patient education on proper medication administration is vital to prevent adverse events.