Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Letters   |    
Donepezil-Associated Sick Sinus Syndrome
Lokesh Shahani, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E05. doi:10.1176/appi.neuropsych.12110270
View Author and Article Information

Dept. of Internal Medicine
Southern Illinois University School of Medicine
Springfield, IL

Copyright © 2014 by the American Psychiatric Association


To the Editor: Sick sinus syndrome (SSS) is characterized by dysfunction of the sinoatrial (SA) node that is often secondary to degeneration of the SA node and surrounding atrial myocardium. This could result in profound sinus bradycardia, sinus pauses, sinus arrest, SA nodal exit block, and inappropriate responses to physiological demands during exercise or stress. SSS can also be accompanied by AV nodal conduction disturbances and by paroxysmal supraventricular tachycardia as part of the tachycardia–bradycardia syndrome. Patients may present with symptoms of fatigue, lightheadedness, presyncope, syncope, dyspnea on exertion, angina, and/or palpitations. Drugs that depress sinus node function, including drugs that increase cholinergic tone, have been associated with SSS.

Figures in this Article

First Page Preview

View Large
First page PDF preview
Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).



Naranjo  CA;  Busto  U;  Sellers  EM  et al:  A method for estimating the probability of adverse drug reactions.  Clin Pharmacol Ther 1981; 30:239–245
[CrossRef] | [PubMed]
Bordier  P;  Lanusse  S;  Garrigue  S  et al:  Causes of syncope in patients with Alzheimer’s disease treated with donepezil.  Drugs Aging 2005; 22:687–694
[CrossRef] | [PubMed]
References Container

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 12.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 12.  >
What Your Patients Need to Know About Psychiatric Medications, 2nd Edition > Chapter 73.  >
APA Practice Guidelines > Chapter 16.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
PubMed Articles
Donepezil-associated sick sinus syndrome. J Neuropsychiatry Clin Neurosci 2014;26(1):E5.