To the editor:
A colleague in family medicine recently described the case of an elderly patient with angina who presented to the emergency department secondary to an anginal attack. The angina was treated with nitroglycerin and resulted in the patient succumbing to a coronary event. During the aftermath, it became clear to the family physician that this patient committed suicide and may have feigned an anginal attack. Unbeknownst to the emergency physician, the patient had obtained sildenafil citrate from another family physician and was made aware of the adverse cardiac events related to concomitantly taking nitroglycerin and sildenafil citrate.1 As verified by collateral sources, this patient planned to commit suicide using this method. The same family physician reported that he was following up another elderly man with depression who requested a similar option for committing suicide. Hopefully this letter can make physicians aware of a new way to commit suicide—sildenafil citrate and nitroglycerin.
Shree Bhalerao, MD
St. Michael’s Hospital
Toronto, Ontario, Canada
- Feldman R and the Sildenafil Study Group. Sildenafil (Viagra) in the treatment of erectile dysfunction: efficacy in patients taking concomitant antihypertensive therapy. Am J Hypertens 1998; 11:10A. Abstract.