Journal Information
Vol. 44. Issue 10.
Pages 571-573 (January 2008)
Share
Share
Download PDF
More article options
Vol. 44. Issue 10.
Pages 571-573 (January 2008)
Case Reports
Full text access
Hypersensitivity Pneumonitis Due to Venlafaxine
Visits
5736
Luis Borderías Claua,
Corresponding author
lborderias@separ.es

Correspondence: Dr L. Borderías Clau Sección de Neumología, Hospital General San Jorge Avda. Martínez de Velasco, 36 22004 Huesca, Spain
, Miguel Ángel Marigil Gómezb, Pascual Val Adána, Mariano Marcén Letosaa, Rosa Biescas Lópeza, Francisco Garrapiz Lópeza
a Sección de Neumología, Hospital General San Jorge, Huesca, Spain
b Sección de Anatomía Patológica, Hospital General San Jorge, Huesca, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

Venlafaxine is a selective serotonin, noradrenalin, and dopamine reuptake inhibitor. Although side effects are rare, venlafaxine has very occasionally been associated with hypersensitivity pneumonitis. We report the case of a 61-year-old woman diagnosed with depressive disorder and treated with venlafaxine (Dobupal) at a dose of 150 mg/d for 18 months. When depression worsened, the dose was increased to 255 mg/d. Three weeks later she complained of nonproductive cough, shortness of breath with moderate effort, and asthenia. Clinical and radiologic findings, lung function, bronchoalveolar lavage, and histology of lung biopsies all indicated a diagnosis of hypersensitivity pneumonitis. Other causes were ruled out and venlafaxine was discontinued. Clinical, radiologic, and lung function findings then resolved without the use of corticosteroids or nonsteroid immune modulators. All findings were normal on follow-up after 3 months.

Key words:
Hypersensitivity pneumonitis
Venlafaxine
Adverse effects, drugs

La venlafaxina es un antidepresivo que inhibe de forma selectiva la recaptación de serotonina, noradrenalina y dopamina. Los efectos secundarios son infrecuentes y excepcionalmente se ha asociado a neumonitis por hipersensibilidad. Describimos el caso de una mujer de 61 años diagnosticada de síndrome depresivo y tratada con Dobupal® (venlafaxina), a dosis de 150 mg/24 h, desde hacía 18 meses, que presentó un deterioro de su enfermedad, por lo que se incrementó la dosis de venlafaxina hasta 225 mg/día. Tres semanas después desarrolló síntomas de tos no productiva, disnea a esfuerzos moderados y astenia. El cuadro clinicorradiológico, los hallazgos en la función pulmonar, el lavado broncoalveolar y la histología de las biopsias pulmonares eran indicativos de neumonitis por hipersensibilidad. Se descartaron otras etiologías y se retiró la venlafaxina sin utilizar corticoides ni otros inmunomoduladores, con lo que desaparecieron tanto la clínica como los hallazgos radiológicos y funcionales, que se normalizaron a los 3 meses.

Palabras clave:
Neumonitis por hipersensibilidad
Venlafaxina
Reacción adversa a drogas y fármacos
Full text is only aviable in PDF
References
[1]
SM Holliday, P Benfield.
Venlafaxine. A review of its pharmacology and therapeutic potential in depression.
Drugs, 49 (1995), pp. 280-294
[2]
ME Thase.
Selective serotonin-norepinephrine reuptake inhibitors.
Kaplan and Sadock's comprehensive textbook of psychiatry, 8th ed., pp. 2881-2884
[3]
O Melien, T Skaali, K Myhr, O Brórs.
Venlafaxine and asthma.
Nord J Psychiatry, 59 (2005), pp. 538-540
[4]
MC Fleisch, F Blauer, JHG Gubler, M Kuhn, TA Scherer.
Eosinophilic pneumonia and respiratory failure associated with venlafaxine treatment.
Eur Respir J, 15 (2000), pp. 205-208
[5]
CM Oermann, KS Panesar, C Langstom, GL Larsen, AA Menéndez, DE Schofield, et al.
Pulmonary infiltrates with eosinophilia syndromes in children.
J Pediatr, 136 (2000), pp. 351-358
[6]
M Drent, S Singh, APM Gorgels, DM Hansell, O Bekers, AG Nicholson, et al.
Drug induced pneumonitis and heart failure simultaneously associated with venlafaxine.
Am J Respir Crit Care Med, 167 (2003), pp. 958-961
[7]
RC Turner, JE Nelson, BT Roberts, DM Gillam.
Venlafaxine associated interstitial pneumonitis.
Pharmacotherapy, 25 (2005), pp. 626-629
[8]
WJ Pichler.
Delayed drug hypersensitivity reactions.
Ann Intern Med, 139 (2003), pp. 683-693
[9]
P Camus, P Foucher, P Bonniaud, K Ask.
Drug-induced infiltrative lung disease.
Eur Respir J, 18 (2001), pp. 93-100
[10]
F Carrión, J Marín.
Toxicidad pulmonar por fármacos.
Arch Bronconeumol, 35 (1999), pp. 550-559
[11]
R Hubbard, A Venn, C Smith, M Cooper, I Johnston, J Britton.
Exposure to common prescribed drugs and the etiology of cryptogenetic fibrosing alveolitis.
Am J Respir Crit Care Med, 157 (1998), pp. 743-747
[12]
SP Bass, HJH Coletbbatch.
Fluoxetine induced lung damage.
Med J Austr, 156 (1992), pp. 364-365
[13]
M Haro, M Rubio, J Puig.
Enfermedad pulmonar asociada a la administración de fluoxetina.
Arch Bronconeumol, 38 (2002), pp. 153
[14]
E Kervelier, J Trédaniel, G Revlon, O Groussard, G Zalcman, JM Ortoli, et al.
Fluoxetin-induced pulmonary granulomatosis.
Eur Respir J, 9 (1996), pp. 615-617
[15]
E Lessard, MA Yessine, BA Hamelin, G O'Hara, J LeBlanc, J Turgeon.
Influence of CYP 2D6 activity on the deposition and cardiovascular toxicity of the antidepressant agent venlafaxine in humans.
Pharmacogenetics, 9 (1999), pp. 435-443
[16]
ME Shams, B Arneth, C Hiemke, A Dragicevic, MJ Müller, R Kaiser, et al.
CYP2D6 polymorphism and clinical effect of the antidepressant venlafaxine.
J Clin Pharm Ther, 31 (2006), pp. 493-502
[17]
SJ Posadas, WJ Pichler.
Delayed drug hypersensitivity reactions –new concepts.
Clin Exp Allergy, 37 (2007), pp. 989-999
[18]
MA Capelozzi, EA Leick-Maldonado, ER Parra, MA Martins, IF Tiberio, VL Capelozzi.
Morphological and functional determinants of fluoxetine (Prozac)-induced pulmonary disease in an experimental model.
Respir Physiol Neurobiol, 156 (2007), pp. 171-178
[19]
CA Naranjo, U Busto, EM Sellers, P Sandor, I Ruiz, EA Roberts, et al.
A method for estimating the probability of adverse drug reactions.
Clin Pharmacol Ther, 30 (1981), pp. 239-245
[20]
M Pirmohamed, S James, S Meakin, C Green, AK Scott, TJ Walley, et al.
Adverse drug reactions as cause of admission to hospital:prospective analysis of 18 820 patients.
Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?