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Verapamil: a new antimanic drug with potential interactions with lithium
The Journal of Clinical Psychiatry
|September 1, 1987
Summary
Combining verapamil and lithium carbonate in elderly patients may cause severe bradycardia and myocardial infarction. Caution is advised when prescribing these medications together due to potential cardiovascular interactions.
Area of Science:
- Cardiology
- Pharmacology
- Psychiatry
Background:
- Verapamil, a calcium channel blocker, has shown potential in managing mania.
- Lithium carbonate is a common treatment for bipolar disorder and mania.
Observation:
- Two elderly patients with mania experienced profound bradycardia while on combined verapamil and lithium therapy.
- One patient subsequently suffered a fatal myocardial infarction.
Findings:
- The combination of verapamil and lithium carbonate can lead to dangerous cardiovascular events, including bradycardia and myocardial infarction.
- Elderly patients may be particularly susceptible to these adverse effects.
Implications:
- Clinicians should exercise extreme caution when prescribing verapamil and lithium carbonate concurrently, especially in elderly patients.
- Further research into the mechanisms underlying the cardiovascular interactions between verapamil and lithium is warranted.
- Monitoring for bradycardia and other cardiac complications is crucial in patients receiving this drug combination.