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Donepezil and Memantine-Induced Second-Degree Atrioventricular Block: A Case Report.
Manjappa Mahadevappa1, Sakeer Hussain2, Shivananda Manohar3
1Department of Cardiology JSS Medical College & Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Hospital Pharmacy
|November 15, 2024
Summary
Donepezil and memantine, used for Alzheimer's disease, can rarely cause heart rhythm issues like atrioventricular block. Discontinuation of these drugs led to complete recovery of heart function in a patient.
Area of Science:
- Pharmacology
- Cardiology
- Neurology
Background:
- Donepezil and memantine are commonly prescribed for Alzheimer's disease.
- Donepezil inhibits acetylcholinesterase; memantine antagonizes NMDA receptors.
- These drugs target neural pathways to improve cognitive function.
Observation:
- A rare case of cardiac adverse drug reaction is presented.
- An 81-year-old male patient with Alzheimer's disease and schizophrenia experienced a second-degree atrioventricular block.
- The patient was concurrently treated with oral donepezil and memantine.
Findings:
- The patient's second-degree atrioventricular block resolved within 2-3 weeks after discontinuing donepezil and memantine.
- A short course of sympathomimetic drugs was also administered.
- This suggests a potential link between donepezil-memantine therapy and atrioventricular block.
Implications:
- Clinicians should be aware of rare cardiovascular adverse effects associated with donepezil and memantine.
- Monitoring for cardiac complications is crucial in patients receiving these medications.
- This case highlights the importance of considering drug-induced causes for bradyarrhythmias.
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