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Venlafaxine dependence in a patient with a history of alcohol and amineptine misuse
Gianluca Quaglio1, Fabrizio Schifano, Fabio Lugoboni
1Medical Service for Addictive Disorders, Department of Internal Medicine, University of Verona, Policlinico G.B. Rossi, Verona, Italy. gianluca.quaglio@azosp.vr.it
Background:
Venlafaxine is an inhibitor of neuronal serotonin and noradrenaline re-uptake and a weak inhibitor of dopamine re-uptake. There was no indication of problems of abuse/dependence during the clinical trials.
Case Description:
A 53-year-old client with a history of alcohol and amineptine misuse and a long history of recurrent depression, for which he was prescribed venlafaxine tablets. Over time, he increased the dosage to 50 tablets daily (3750 mg). Large venlafaxine dosages produced amphetamine-like effects, due possibly to the related increase in dopamine turnover. Once hospitalized for detoxification, the patient had a symptomatology which was consistent with a serotonergic discontinuation syndrome.
Conclusions:
Physicians should be aware that patients with a history of drug and alcohol abuse might develop venlafaxine dependence.
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