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The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Related Experiment Video

Updated: Feb 16, 2026

Signal Attenuation as a Rat Model of Obsessive Compulsive Disorder
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Paroxetine-induced QTc prolongation.

Yuji Otsuka1

  • 1Department of Psychiatry Asahi General Hospital Asahi Chiba Japan.

Journal of General and Family Medicine
|December 22, 2017
PubMed
Summary

This case report details a rare instance of paroxetine causing corrected QT (QTc) prolongation, a potentially serious heart rhythm issue. The condition resolved after discontinuing the medication, highlighting paroxetine

Area of Science:

  • Cardiology
  • Pharmacology
  • Genetics

Background:

  • Corrected QT (QTc) prolongation is a critical indicator of cardiac repolarization abnormalities.
  • Drug-induced QTc prolongation poses a significant risk for potentially fatal arrhythmias.
  • Paroxetine, a selective serotonin reuptake inhibitor (SSRI), has been rarely associated with QTc prolongation.

Observation:

  • A 43-year-old woman presented with QTc prolongation (476 ms) after 17 days of paroxetine (50 mg/day).
  • Electrocardiogram (ECG) monitoring revealed significant QTc interval lengthening.
  • Symptoms resolved within three days of paroxetine discontinuation, with QTc returning to normal (396 ms).

Findings:

  • Paroxetine was identified as the likely cause of the observed QTc prolongation.
Keywords:
ECGHERGQTc prolongationSSRIparoxetine

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  • The mechanism may involve the blockade of human ether-a-go-go-related gene (HERG) potassium channels by paroxetine.
  • Genetic variations in cardiac ion channels and autonomic nervous system instability may contribute to susceptibility.

    • Implications:

    • This case underscores the importance of monitoring cardiac function in patients taking paroxetine, especially those with risk factors.
    • Understanding the pharmacogenetic and physiological factors influencing drug-induced QTc prolongation is crucial for patient safety.
    • Further research into the relationship between SSRIs, HERG channel function, and cardiac events is warranted.