Key result
Carbamazepine blood concentration linked to a transient Brugada pattern that resolves upon drug withdrawal.
Why the study?
Carbamazepine-induced Brugada-type electrocardiographic changes and their association with drug concentration versus hypothyroidism were unclear.
Case Report (n=1)
No
Carbamazepine at the upper limit of the standard range can induce a transient Brugada-type electrocardiographic pattern that resolves upon drug withdrawal.
Carbamazepine may induce transient Brugada ECG changes; single case leaves association and monitoring implications open.
We report the case of a 61-year-old man with schizophrenia who was treated with carbamazepine, in whom electrocardiography showed transient Brugada-type ST elevation. He had been hospitalized our hospital's Department of Psychiatry and had been diagnosed with pneumonia. On the following day, electrocardiography showed coved-type ST elevation in the right precordial leads and a blood examination revealed that the patient's carbamazepine concentration was at the upper limit of the standard range, as well as hypothyroidism. The patient's electrocardiogram normalized after the withdrawal of carbamazepine. We demonstrated that the patient's carbamazepine concentration-and not hypothyroidism-was associated with the serial electrocardiographic changes by monitoring the patient's blood concentration of carbamazepine and his thyroid function.
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Ota et al. (2017) conducted a case report in Schizophrenia and Brugada-type electrocardiographic pattern (n=1). Carbamazepine was evaluated on Electrocardiographic changes (Brugada-type ST elevation). A patient with schizophrenia developed a transient coved-type Brugada electrocardiographic pattern that correlated with his blood concentration of carbamazepine and resolved upon its withdrawal.
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