A 68-Year-Old Man with Depression and Acute Renal Failure Due to Rhabdomyolysis Associated with Alcohol Intoxication While Taking Low-Dose Escitalopram: A Case Report.

Publisher: International Scientific Information, Inc Country of Publication: United States NLM ID: 101489566 Publication Model: Electronic Cited Medium: Internet ISSN: 1941-5923 (Electronic) Linking ISSN: 19415923 NLM ISO Abbreviation: Am J Case Rep Subsets: MEDLINE

Publication: <2014- > : Smithtown, NY : International Scientific Information, Inc.
Original Publication: Albertson, NY : International Scientific Literature, Inc.

Acute Kidney Injury*/chemically induced ; Alcoholic Intoxication*/complications ; Rhabdomyolysis*/chemically induced ; Selective Serotonin Reuptake Inhibitors*/adverse effects; Aged ; Humans ; Male

BACKGROUND Rhabdomyolysis, an uncommon but recognized adverse effect of selective serotonin reuptake inhibitor (SSRI) antidepressants, can precipitate acute renal injury (AKI), especially when combined with risk factors such as alcohol consumption. This report describes a 68-year-old man with acute renal failure due to rhabdomyolysis associated with alcohol intoxication while taking low-dose escitalopram, an SSRI antidepressant. CASE REPORT The patient, with a history of bipolar affective disorder managed with escitalopram, presented with symptoms of general malaise, diarrhea, myalgias, and transient loss of consciousness following substantial ethanol consumption. Laboratory tests indicated severe rhabdomyolysis with a creatine kinase level of 37 672 U/L and myoglobin level >5710 ng/ml, leading to an AKI diagnosis. The discontinuation of escitalopram, along with hydration and renal replacement therapy, facilitated renal recovery. However, the reintroduction of escitalopram resulted in the recurrence of rhabdomyolysis, suggesting a probable causal link, confirmed using the Naranjo Adverse Drug Reaction Probability Scale. CONCLUSIONS This report highlights the importance of identifying the medication history in patients presenting with acute renal failure and rhabdomyolysis and the association with SSRIs, which can be exacerbated by alcohol. This case underscores the importance of vigilant medication history assessment in patients presenting with AKI and rhabdomyolysis, particularly concerning the use of SSRIs like escitalopram, which can pose heightened risks in the context of alcohol use. It highlights the need for clinical caution in managing patients on long-term SSRI therapy, especially when reintroducing such medications after an episode of rhabdomyolysis.

J Med Case Rep. 2021 Dec 19;15(1):627. (PMID: 34924025)
Pediatr Nephrol. 2011 Oct;26(10):1781-8. (PMID: 21249398)
Cureus. 2019 Mar 6;11(3):e4197. (PMID: 31106097)
Nephrol Dial Transplant. 2018 Dec 1;33(12):2113-2114. (PMID: 30508119)
Ren Fail. 2021 Dec;43(1):1561-1568. (PMID: 34839765)
Sci Rep. 2023 Jul 28;13(1):12257. (PMID: 37507539)
Front Endocrinol (Lausanne). 2023 Sep 22;14:1257078. (PMID: 37810894)
Eur J Pediatr. 2023 Mar;182(3):1371-1375. (PMID: 36662269)
Surgery. 2022 May;171(5):1412-1416. (PMID: 35078633)
Healthcare (Basel). 2022 Jun 29;10(7):. (PMID: 35885744)
Front Physiol. 2019 May 28;10:650. (PMID: 31191348)
Ulster Med J. 2021 May;90(2):61-69. (PMID: 34276082)
Eur J Anaesthesiol. 2016 Dec;33(12):906-912. (PMID: 27259093)
Neuromuscul Disord. 2023 Feb;33(2):183-186. (PMID: 36652875)
Eur Arch Psychiatry Clin Neurosci. 2023 Feb;273(1):75-83. (PMID: 36207527)
BMC Pregnancy Childbirth. 2023 Jan 7;23(1):11. (PMID: 36611175)
Iran J Public Health. 2018 Sep;47(9):1424-1425. (PMID: 30320019)
BMC Pediatr. 2022 Aug 30;22(1):515. (PMID: 36042458)
Sci Rep. 2023 Oct 17;13(1):17693. (PMID: 37848606)
J Clin Psychopharmacol. 2011 Apr;31(2):251-3. (PMID: 21364342)
Drug Healthc Patient Saf. 2021 Nov 08;13:211-219. (PMID: 34795533)
Int J Med Sci. 2017 Jun 23;14(7):680-689. (PMID: 28824301)
Crit Care Clin. 2022 Apr;38(2):271-285. (PMID: 35369947)
Eur J Neurol. 2021 Feb;28(2):647-659. (PMID: 32978841)
Am J Case Rep. 2017 Jul 04;18:746-749. (PMID: 28674380)
Rev Environ Health. 2022 Jul 19;38(4):613-620. (PMID: 35852130)
Arch Acad Emerg Med. 2023 Aug 1;11(1):e55. (PMID: 37671275)
Trauma Surg Acute Care Open. 2022 Jan 27;7(1):e000836. (PMID: 35136842)
Front Immunol. 2022 Mar 17;13:845496. (PMID: 35371100)
BMJ Case Rep. 2022 May 19;15(5):. (PMID: 35589265)

0 (Selective Serotonin Reuptake Inhibitors)

Date Created: 20240702 Date Completed: 20240702 Latest Revision: 20240930

20241001

PMC11332971

10.12659/AJCR.943422

38951999