Observations placeholder
Amiodarone, Pacerone and Cordarone
Identifier
005081
Type of Spiritual Experience
Background
A description of the experience
Amiodarone
is available under the trade names Pacerone and Cordarone , Aratac , Arycor, and Atlansil .
It is an antiarrhythmic agent used for various types of tachyarrhythmias (fast forms of irregular heart beat), both ventricular and supraventricular (atrial) arrhythmias. Discovered in 1961, it was not approved for use in the United States until 1985. It is used in arrhythmias that are otherwise difficult to treat with other medications.
It is categorized as a class III antiarrhythmic agent, and “prolongs phase 3 of the cardiac action potential”. It has numerous other effects however, including actions that are similar to those of antiarrhythmic classes Ia, II, and IV.
On Jan, 11, 2017 2,926 people reported to have side effects when taking Amiodarone Hydrochloride. Among them, 11 people (0.38%) have Hallucination
On Jan, 25, 2017 1,639 people reported to have side effects when taking Pacerone.
Among them, 12 people (0.73%) have Sensory Hallucinations
On Jan, 10, 2017 15,362 people reported to have side effects when taking Cordarone.
Among them, 45 people (0.29%) have Hallucination
On Jan, 29, 2017 15,362 people reported to have side effects when taking Cordarone.
Among them, 10 people (0.07%) have Hallucination, Auditory
Wikipedia based analysis
There may be a number of possible actions which each contribute to its effects.
Channel blocker/beta blocker - Amiodarone shows beta blocker-like and potassium channel blocker-like actions but is not classed as either a beta blocker or a channel blocker. But it does increase the refractory period via sodium- and potassium-channel effects, and slows intra-cardiac conduction of the cardiac action potential, via sodium-channel effects. Thus one of the possible mechanisms is that it mimics a channel blocker .
If you have too much of the drug, in effect you over-dose accidentally it can lead to hypotension, low blood pressure via a similar route to a channel blocker [see separate section]. Hypotension may then lead to hypoxia, which in turn leads to the mind shutting down the reasoning function and memory as a first line of protection against the system failing, principally because reasoning and memory require considerable supplies of energy and that energy is needed to keep you alive in other areas!
If you thus overdose accidentally you get hypoxia induced spiritual experience, although it may be a none too pleasant one.
Thyroid activity - Amiodarone resembles thyroid hormone, and its binding to the nuclear thyroid receptor might contribute to some of its pharmacologic [and toxic] actions. Due to the iodine content of the agent (37.3% by weight), abnormalities in thyroid function are common. Amiodarone is structurally similar to thyroxine (a thyroid hormone), which contributes to the effects of amiodarone on thyroid function. Both under- and overactivity of the thyroid may occur on amiodarone treatment. In this case the drug is acting like a thyroid drug, the mechanisms by which these work is also described in a separate section
Toxic effects – There may be some hallucinations that are caused by toxic reactions to other drug interactions or to interaction with some food stuffs. Any toxic reaction can cause hallucinations through delirium.
Amiodarone is extensively metabolized in the liver by cytochrome P450 3A4, for example, and can affect the metabolism of numerous other drugs. It interacts with digoxin, warfarin, phenytoin and others - Cyclosporine , Flecainide, Procainamide, Quinidine, Sildenafil, and Theophylline
The major metabolite of amiodarone is desethylamiodarone (DEA), which also has antiarrhythmic properties. The metabolism of amiodarone is inhibited by grapefruit juice, leading to elevated serum levels of amiodarone.
On August 8, 2008 FDA issued a warning of the risk of rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone.
Lung failure - The most serious reaction that is due to amiodarone is interstitial lung disease. Some individuals were noted to develop pulmonary fibrosis after a week of treatment, while others did not develop it after years of continuous use. Common practice is to avoid the agent if possible in individuals with decreased lung function, but any form of lung malfunction has the effect of producing hypoxia [see separate section on hypoxia].
Amiodaronepulmonarytoxicity - Wolkove N, Baltzan M; Mount Sinai Hospital Centre, McGill University, Montreal, Canada.
Amiodarone is an antiarrhythmic agent commonly used to treat supraventricular and ventricular arrhythmias. This drug is an iodinecontaining compound that tends to accumulate in several organs, including the lungs. It has been associated with a variety of adverse events. Of these events, the most serious is amiodarone pulmonary toxicity. Although the incidence of this complication has decreased with the use of lower doses of amiodarone, it can occur with any dose. Because amiodarone is widely used, all clinicians should be vigilant of this possibility. Pulmonary toxicity usually manifests as an acute or subacute pneumonitis, typically with diffuse infiltrates on chest x-ray and high-resolution computed tomography. Other, more localized, forms of pulmonary toxicity may occur, including pleural disease, migratory infiltrates, and single or multiple nodules. With early detection, the prognosis is good. Most patients diagnosed promptly respond well to the withdrawal of amiodarone and the administration of corticosteroids, which are usually given for four to 12 months. It is important that physicians be familiar with amiodarone treatment guidelines and follow published recommendations for the monitoring of pulmonary as well as extrapulmonary adverse effects.
Degeneration of the eyes – One of the side effects of amiodarone is a deterioration in sight. Corneal micro-deposits (Corneal verticillata, also called vortex keratopathy) are almost universally present (over 90%) in individuals taking amiodarone for at least 6 months. These deposits typically do not cause any symptoms. About 1 in 10 individuals may complain of a bluish halo. Optic neuropathy occurs in 1-2% of people and is not dosage dependent. Bilateral optic disk swelling and mild and reversible visual field defects can also occur. In the section on blindness we saw that various forms of visual deterioration can themselves cause hallucinations
Liver failure - Abnormal liver enzyme results are common in patients on amiodarone. Much rarer are jaundice, hepatomegaly (liver enlargement), and hepatitis (inflammation of the liver). Low-dose amiodarone has been reported to cause pseudo-alcoholic cirrhosis. In this case amiodarone is possibly acting in much the same way that we see in those with alcoholism – see the separate section on Brain damage and alcoholism
In summary - Overall therefore, the number of mechanisms by which amiodarone is having its effects are multiple and various and are very dependent on which side effects are being experienced. Given that all of them may occur, the hallucinations could be provoked by multiple mechanisms.