# 51 - References

# References

Drug treatment of psychiatric symptoms in the context of other conditions 
CHAPTER 10
References
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Condition
Suggested drugs
Drugs to avoid
Anxiety disorders
(anxiety symptoms increase 
risk of AF)45
Benzodiazepines (although a 
2022 cohort study found a 
hugely increased risk of incident 
AF in benzodiazepine users46)
SSRIs (see above)
Tricyclics (see above)
Several reported cases of pregabalin-­ and 
gabapentin-­associated AF47,48 and one 
cohort study suggested increased risk of 
AF49 with both drugs
Promethazine may increase the risk of 
being hospitalised with AF50
Alzheimer’s disease
Acetylcholinesterase inhibitors 
(but beware bradycardic effects 
in patients with paroxysmal 
’vagal’ AF [paroxysmal AF 
provoked by low heart rate])
Rivastigmine has least 
interaction potential
Memantine may be able to 
prevent and terminate AF51
Avoid cholinesterase inhibitors in 
paroxysmal ‘vagal’ AF
AV, atrioventricular; DOACs, direct-­acting oral anticoagulants.
Table 10.15  (Continued)

848
The Maudsley® Prescribing Guidelines in Psychiatry
CHAPTER 10
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45. Eaker ED, et al. Tension and anxiety and the prediction of the 10-­year incidence of coronary heart disease, atrial fibrillation, and total mortality: the Framingham Offspring Study. Psychosom Med 2005; 67:692–696.
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8:76.