A man went to the hospital with a life-threatening illness after doing things more than a million Americans do every day: taking antidepressants and drinking.
The anonymous patient had been taking the popular antidepressant escitalopram, better known in the United States by the brand name Lexapro.
He was an occasional drinker and one day, after consuming “substantial” amounts of alcohol, he developed muscle aches, tremors and fainted.
Doctors theorized that his Lexapro had caused his muscles to break down spontaneously, leaking bits of damaged tissue into his blood, blocking his kidneys and causing life-threatening kidney failure.
The patient had a history of bipolar disorder and moderate alcohol consumption. Doctors did not specify how much he had drunk before coming to the emergency room, but described it as “substantial.”
In rare cases, muscle tissue breakdown can lead to kidney failure. Some case reports have linked this condition to antidepressants.
Researchers aren’t sure how antidepressants might cause this rapid muscle deterioration, but one theory is that they cause prolonged muscle contractions, leading to cell damage.
The case, which occurred in Romania in 2023, was revealed in the American Journal of Case Reports saying.
“The findings underscore the need for rigorous and ongoing monitoring of renal function in individuals undergoing long-term treatment with psychiatric medications, regardless of dose levels,” the study authors said.
Approximately 43 million Americans were taking antidepressants in 2018, the highest number Recent data available from the CDC national trends.
The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs), medications that increase the amount of serotonin, a neurotransmitter that controls mood, sleep, and sexual desire.
According to one study, more than 70 percent of Americans who use antidepressants take SSRIs. Rush University Research.
Popular brands include Zoloft, Prozac, and Lexapro. Lexapro Official FDA Label It is not recommended to drink alcohol while taking the medication.
In the case of the Romanian patient, he had been using different types of psychiatric medications to treat his bipolar disorder for at least five years.
His current cocktail included Lexapro, anti-seizure medications and alcohol.
When he arrived at the County Emergency Clinical Hospital in Bucharest, Romania, the man had diarrhea, muscle aches, tremors and high blood pressure for two days and had passed out after drinking “substantial” amounts of alcohol.
They discovered he had rhabdomyolysis, a rare disease in which muscle cells break down rapidly and leak material into the bloodstream, blocking the kidneys and causing kidney failure.
He probably passed out from the alcohol consumption because his kidneys had already stopped working, so his body was not able to filter the effects from his blood efficiently.
Doctors wrote that it was not that the condition was caused by alcohol, but that alcohol probably exacerbated it.
After doctors took him off Lexapro and put him on IV fluids, he stabilized.
But when she was put back on the drug, her condition began to return, leading doctors to theorize that the SSRI had caused the rare condition in the first case.
Doctors aren’t sure how common this is or how SSRIs can cause it. They have seen it in a few other cases, including a teenager in Norway in 2023a 25-year-old woman New York in 2016 and a 13 year old boy in New York in 2018.
Lexapro belongs to a popular class of antidepressants that act on the neurotransmitter serotonin. Similar drugs include Zoloft and Prozac.
It could be that taking selective serotonin reuptake inhibitors, which increase the amount of this neurotransmitter in the system in the hope of improving mood, also causes muscles to contract.
Researchers from Norway He suggested that it is possible that these drugs cause muscles to contract or tense for a prolonged period of time, causing them to break down and leak into the blood.
In other cases, this leaky muscle cell syndrome occurs when someone’s muscles are injured or they are put on bed rest for too long.
This syndrome is just one of many things that can cause kidneys to fail.
Most commonly, conditions such as diabetes, high blood pressure, heart disease or a long history of taking medications that can harm the kidneys, such as over-the-counter painkillers, lead to the condition.
In total, approximately 750,000 Americans suffer from kidney failure each year.
The kidneys are responsible for filtering toxins from the body. Therefore, when they function more slowly or stop working, nausea, vomiting, fatigue, confusion, swelling and muscle cramps occur.
Over time, if left untreated, this can lead to death.
The scientists who published the case study wrote that this rare condition should be something doctors should consider when prescribing SSRIs to their patients, and they should take note if they have a family history of kidney disease or alcohol use.