Tricyclic Antidepressants and Cardiovascular Effects

摘要

A group of patients with both serious depression and cardiovascular disease were studied to examine: (a) the propensity of nortriptyline to impair left ventricular function; (b) the effects of nortriptyline in depressed patients with pre-existing conduction effects; and, (c) the effects of cardiovascular disease and its associate medications on the pharmacokinetics of nortriptyline. No further impairment was found in left ventricular function. It was found that the degree of pre-existing conduction disease determines the patient's risk rather than the specific tricyclic. It was also found that patients with impaired left ventricular function had markedly impaired drug clearance and plasma levels of antidepressant drugs that were nearly double those seen in controls.