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Confusion and paranoia associated with oral tocainide
Postgraduate Medical Journal
|January 1, 1985
Summary
Tocainide, an antiarrhythmic drug, can cause severe confusion and hallucinations in patients with impaired renal function. Symptoms resolved upon drug discontinuation, indicating a potential link between tocainide and central nervous system side effects.
Area of Science:
- Pharmacology
- Neuroscience
- Nephrology
Background:
- Tocainide is an oral antiarrhythmic agent.
- Adverse central nervous system (CNS) effects of tocainide are not well-documented.
Observation:
- Two middle-aged female patients experienced hallucinations, confusion, and paranoia during tocainide treatment.
- Both patients exhibited impaired renal function.
Findings:
- Tocainide administration, even at recommended doses, may precipitate severe CNS toxicity.
- Re-challenge confirmed the causal link in one patient.
- Elevated tocainide blood levels were noted in the second patient.
Implications:
- Clinicians should exercise caution when prescribing tocainide to patients with renal impairment.
- Monitoring for neurological side effects is crucial in patients receiving tocainide.
- Renal function may influence tocainide metabolism and CNS toxicity risk.