Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-07T20:15:54.108Z Has data issue: false hasContentIssue false

Cardiac Effects of Different Tricyclic Antidepressant Drugs

Published online by Cambridge University Press:  29 January 2018

G. D. Burrows
Affiliation:
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria 3050
J. Vohra
Affiliation:
Department of Cardiology, Royal Melbourne Hospital, Victoria 3050
D. Hunt
Affiliation:
Department of Cardiology, Royal Melbourne Hospital, Victoria 3050
J. G. Sloman
Affiliation:
Department of Cardiology, Royal Melbourne Hospital, Victoria 3050
B. A. Scoggins
Affiliation:
Howard Florey Institute of Experimental Physiology and Medical Research, University of Melbourne, Parkville, Victoria 3052
Brian Davies
Affiliation:
University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia

Summary

The effects of tricyclic antidepressants on the heart are reviewed. Statistically significant increases in heart rate and in atrioventricular conduction times were found following the administration of tricyclic drugs to 32 depressed patients. The method of His bundle electrocardiography was used to study atrioventricular conduction in ambulant patients and in patients admitted after an overdose of tricyclic antidepressant drugs. Distal conduction defects were frequently found in patients following tricyclic overdosage, but these were not seen with doxepin overdosage. Impaired distal conduction was also found in occasional patients on therapeutic doses of tricyclic drugs. Some animal experiments giving similar results to the above clinical findings are also described. The clinical implications of these findings are discussed.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1976 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bickel, M. H. (1975) Poisoning by tricyclic antidepressant drugs. International Journal of Clinical Pharmacology, 11, 145—76.Google ScholarPubMed
Boston Collaborative Druo Surveillance Programme Report (1972) Adverse reactions to the tricyclic antidepressant drugs. Lancet, i, 529—31.Google Scholar
Burrows, G. D., Davies, B. & Scoggins, B. A. (1972) Plasma concentrations of nortriptyline and clinical response in depressive illness. Lancet, ii, 619—23.Google Scholar
Burrows, G. D., Mowbray, R. M. & Davies, B. (1972) A sequential comparison of doxepin (Sinequan) and placebo in depressed patients. Medical Journal of Australia, i, 364—6.Google Scholar
Coull, D. C., Crooks, J., Dingwall-Fordyce, I., Scott, A. & Weir, R. D. (1970) Amitriptyline and cardiac disease. Risk of sudden death identified by monitoring system. Lancet, ii, 590.CrossRefGoogle Scholar
Dumovic, P. Effects of different tricyclic drugs on the heart. (In press).Google Scholar
Gram, L. F. & Fredricson Overö, K. (1972) Drug interaction. Inhibiting effect of neuroleptics on metabolism of tricyclic antidepressants in man. British Medical Journal, i, 463—5.Google Scholar
Hunt, D. & Vohra, J. (1973) Clinical application of His bundle electrocardiography. Medical Journal of Australia, i, 373—5.Google Scholar
Jefferson, J. W. (1975) A review of cardiovascular effects and toxicity of tricyclic antidepressants. Psychosomatic Medicine, 37, 160—79.CrossRefGoogle ScholarPubMed
Moir, D. C., Crooks, J., Cornwell, W. B., O'Malley, M., Dingwall-Fordyce, I., Turnbull, M. J. & Weir, R. D. (1972) Cardiotoxicity of amitriptyline. Lancet, ii, 561—4.Google Scholar
Vohra, J. & Burrows, G. D. (1974) Cardiovascular complications of tricyclic antidepressant overdosage. Drugs, 8, 432—7.CrossRefGoogle ScholarPubMed
Vohra, J., Burrows, G. D. & Sloman, J. G. (1975) Assessment of cardiovascular side effects of therapeutic doses of tricyclic antidepressant drugs. Australia and New Zealand Journal of Medicine, 5, 711.CrossRefGoogle Scholar
Vohra, J., Hunt, D., Burrows, G. D. & Sloman, G. (1975) Intracardiac conduction defects following overdose of tricyclic antidepressant drug. European Journal of Cardiology, 2/4, 453—8.Google Scholar
Vohra, J., Burrows, G. D., Hunt, D. & Sloman, G. (1975) The effect of toxic and therapeutic doses of tricyclic antidepressant drugs on intracardiac conduction. European Journal of Cardiology, 3, 219—27.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.