Dysrhythmia Associated With Fluoxetine Treatment in an Elderly Patient With Cardiac Disease

Although fluoxetine has been shown to be effective & well tolerated, few data are available on the use of this drug in patients with preexisting heart disease & in the elderly. The authors report a case of an elderly patient, with depressive symptoms & suicidal ideation, in whom atrial fibrillation & bradycardia developed shortly after treatment with fluoxetine began. The dysrhythmias recurred on rechallenge with the drug. A literature review & possible pathophysiologic mechanisms are discussed.