Takotsubo Cardiomyopathy Due to Combined Use of Phentermine and Lisdexamfetamine
  • Tara Burleigh
    Department of Family Medicine, University of Nebraska Medical Center, Omaha, NE, USA
  • Khandalavala Birgit
    Department of Family Medicine, University of Nebraska Medical Center, Omaha, NE, USA

Keywords

Phentermine, Takotsubo disease, lisdexamfetamine, sympathetic overstimulation

Abstract

Objectives: This is the first case report of iatrogenic Takotsubo syndrome (TS) due to a combination of lisdexamfetamine and phentermine.
Background: TS is characterized by transient acute ballooning of the left ventricular wall. Typically, it occurs in extremely stressed post-menopausal women, however a few iatrogenic causes have been described recently.
Results: A 55-year old woman prescribed lisdexamfetamine and phentermine, presented with acute substernal chest pain. Acute coronary syndrome was excluded. The echocardiogram was diagnostic of TS, and she recovered spontaneously, with supportive care.
Conclusion: Caution with the use of sympathomimetic medications in post-menopausal women appears warranted.

VIEW THE ENTIRE ARTICLE

References

  • Ono R, Falcão LM. Takotsubo cardiomyopathy systematic review: pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy. Int J Cardiol 2016; 209:196–205.

  • Sato H, Tateishi H, Uehida T. Takotsubo-like cardiomyopathy due to multi-vessel spasm. In: Kodama K, Haze K, Hon M, editors. Clinical Aspect of Myocardial Injury: From Ischemia To Heart Failure [in Japanese]. Tokyo: Kagakuhyouronsya Publishing Co; 1990: p. 56–64.

  • Yerasi C, Koifman E, Weissman G, Wang Z, Torguson R, Gai J, et al. Impact of triggering event in outcomes of stress-induced (Takotsubo) cardiomyopathy. Eur Heart J Acute Cardiovasc Care 2017;6(3):280–286.

  • Amariles P, Cifuentes L. Drugs as possible triggers of Takotsubo cardiomyopathy: a comprehensive literature search–update 2015. Curr Clin Pharmacol 2016;11(2):95–109.

  • Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T. Takotsubo cardiomyopathy: pathophysiology, diagnosis and treatment. World J Cardiol 2014;6(7):602–609.

  • Hendricks EJ, Rothman RB, Greenway FL. How physician obesity specialists use drugs to treat obesity. Obesity 2009;17(9):1730–1735.

  • Dziewierz A, Olszanecka A, Wilinski J, Rakowski T, Kleczynski P, Dubiel JS, et al. Inverted takotsubo cardiomyopathy in a patient with essential thrombocythemia exposed to anagrelide and phentermine. Int J Cardiol 2012;160(2):e31–32.

  • Kurisu S, Inoue I, Kawagoe T. Myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352(18):1923–1925; author reply 1923–1925.

  • Alsidawi S, Muth J, Wilkin J. Adderall induced inverted Takotsubo cardiomyopathy. Catheter Cardiovasc Interv 2011;78(6):910–913.

  • Kido K, Guglin M. Drug-induced takotsubo cardiomyopathy. J Cardiovasc Pharmacol Ther 2017;22(6):552–563.

  • Vijay A, Becker JE, Ross JS. Patterns and predictors of off-label prescription of psychiatric drugs. PLoS One 2018;13(7):e0198363.

  • Khanra S, Das B. Off-label psychotropics use: isn't it now an inevitable and a "norm" in psychiatry? Indian J Psychol Med 2018;40(4):390–391.

  • Wittich CM, Burkle CM, Lanier WL. Ten common questions (and their answers) about off-label drug use. Mayo Clin Proc 2012;87(10):982–990.

    • Views: 923
    HTML downloads: 147
    PDF downloads: 438

    Published: 2020-08-05
    Issue: 2020: Vol 7 No 8 (view)

    How to cite:
    1.
    Burleigh T, Birgit K. Takotsubo Cardiomyopathy Due to Combined Use of Phentermine and Lisdexamfetamine. EJCRIM 2020;7 doi:10.12890/2020_001595.