Hydroxyzine-Induced Torsade De Pointes: A Case Report and a Literature Review

Hydroxyzine is an H1-receptor antagonist used for managing allergies, anxiety, opioid withdrawal, and insomnia. An adverse effect of hydroxyzine, QT prolongation, may lead to torsade de pointes (TdP). Our case report literature review highlight the risk TdP with hydroxyzine use. patient, a 58-year-old male implantable cardioverter defibrillator (ICD) history polysubstance abuse presented chest pain shortness breath. During admission, patient started experiencing symptoms which were refractory buprenorphine. 50 mg was administered as recommended symptomatic anxiety relief. Overnight developed TdP, managed by MgSO4, amiodarone, lidocaine, but did not resolve arrhythmia. The sedated intubated, led episode's resolution. This underscore importance cautious prescribing practices other QT-prolonging drugs prevent TdP. Healthcare providers should conduct personalized assessments, monitor electrolyte levels, perform regular electrocardiograms. Administering lowest effective dose, avoiding drug interactions, exercising caution in patients underlying repolarization abnormalities or are crucial. These measures help minimize associated low-dose therapy.