Amantadine, donepezil and memantine associated arrhythmia in an elderly patient

Abstract

<title>Abstract</title> <bold>2.1 Case İnformation</bold> A 78 years old man was referred to the cardiology clinic because of mild dyspnea.Electrocardiography (ECG) showed sinus bradycardia at a rate of 59 beats/min, right bundlebranch block (RBBB), first-degree AV block, and normal QTc duration. One month later, thepatient was readmitted to the cardiology clinic because of worsening dyspnea and arrhythmiadetected by the psychiatrist. It was told that after phsychiatrist prescribed donezepil 5 mg plusmemantine 10 mg combined form and amantadine 100 mg for dementia. His control ECGrevealed interpolated ventricular premature contractions (VPC) with a trigeminy pattern, inaddition to first-degree AV block and RBBB. Anti-dementia medications were discontinuedafter consultation with a neurologist and psychiatrist. The combination of amantadine,donepezil, and memantine caused interpolated VPCs. Arrhythmia of interpolated VPCsdisappeared after drug cessation. Keyword: ventricular premature contraction, amantadine, donepezil, memantine, rightbundle branch block, AV block, bradycardia