Summary
In 40 depressed patients treated with 25 or 50 mg nortriptyline (NT) t. i. d. for 3 weeks the following circulatory variables were observed prior to and during drug therapy: heart rate and blood pressure at rest (in supine and standing positions), working capacity, ECG at rest and during exercise on a bicycle ergometer. During administration of NT the heart rate increased significantly at rest in both supine and standing positions, but the orthostatic heart rate reaction remained unchanged. Diastolic blood pressure in the supine position rose slightly; in the standing position the pretreatment increase in diastolic pressure was abolished. The positive chronotropic effect did not correlate with the steady-state plasma level of NT. In one patient on NT a right bundle branch block appeared during the work test; in the remaining 39 patients the ECG records at rest and during exercise showed no adverse effects of NT.
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References
Cairncross, K. D.: On the peripheral pharmacology of amitriptyline. Arch. int. Pharmacodyn. 154, 438–448 (1965).
Carlsson, A.: Drugs which block the storage of 5-hydroxytryptamine and related amines. In: Handbuch der Exp. Pharmakol. Berlin-Göttingen-Heidelberg: Springer 1965. Ed. V. Erspamer. 19, 529–592.
—: Recent studies on the mode of action of antidepressive drugs. Naunyn-Schmiedebergs Arch. Pharmak. exp. Path. 257, 115–117 (1967).
Freyschuss, U., Sjögvist, F., Tuck, D.: Tyramine pressor effects in man before and during treatment with nortriptyline or ECT: Correlation between plasma level and effect of nortriptyline. Pharmacol. Clin. 2, 72–78 (1970).
Gershon, S., Holmberg, G., Mattson, E., Mattson, N., Marshall, A.: Imipramine hydrochloride. Its effects on clinical autonomic and psychological functions. Arch. gen. Psychiat. 6, 96–101 (1962).
Hammer, W., Brodie, B. B.: Application of isotope derivative technique to assay of secondary amines: Estimation of desipramine by acetylation with H3-acetic anhydride. J. Pharmacol. exp. Ther. 157, 503–508 (1967).
Herrting, G., Axelrod, J.: Fate of tritiated noradrenaline at the sympathetic nerve endings. Nature 192, 172–173 (1961).
Ideström, C.-M., Cadenius, B.: Imipramine-desmethylimipramine. A pharmacological study on human beings. Psychopharmacologia 5, 431–439 (1964).
Klerman, G. L., Cole, J. O.: Clinical pharmacology of imipramine and related antidepressant compounds. Pharmacol. Rev. 17, 101–141 (1965).
Kristiansen, E. S.: Cardiac complications during treatment with imipramine (Tofranil). Acta psychiat. scand. 36, 427–442 (1961).
Muller, O. F., Goodman, N., Bellet, S.: The hypotensive effect of imipramine hydrochloride in patients with cardiovascular disease. Clin. Pharmacol. Ther. 2, 300–307 (1961).
Nymark, M., Rasmussen, J.: Effect of certain drugs upon amitriptyline induced electrocardiographic changes. Acta Pharmacol. 24, 148–165 (1966).
Olsen, A.: Bundle branch block during treatment with antidepressive agents. Ugeskr. Læg. 125, 395–397 (1963).
Pletscher, A.: Biogene Amine und antidepressiver Effekt. Arzneimittel-Forsch. 14, 479–482 (1964).
Rasmussen, E.B., Kristjansen, P.: ECG changes during amitriptyline treatment. Amer. J. Psychiat. 119, 781–782 (1963).
Schou, M.: Electrocardiographic changes during treatment with lithium and with drugs of the imipramine-type. Acta psychiat. scand. 38, 331–336 (1962).
Sjögvist, F., Hammer, W., Borgå, O., Azarnoff, D.L.: Pharmacological significance of the plasma level of monomethylated tricyclic antidepressants. Proc. Coll. Internat. Neuropsychopharmacor. Tarragona, Spain, April 1968, Excerpta Med. Internat. Congr. Ser. No. 180, 128–136 (1969).
Sjöstrand, T.: Experimental variations in the T-wave of the electrocardiogram. Acta med. stand. 138, 191–200 (1950).
—: Clinical Physiology. Stockholm: Scandinavian University Books 1967.
Theobald, W., Büch, O., Kunz, H. A.: Vergleichende Untersuchungen über die Beeinflussung vegetativer Funktionen durch Psychopharmaka im akuten Tierversuch. Arzneimittel-Forsch. 15, 117–125 (1965).
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Freyschuss, U., Sjöqvist, F., Tuck, D. et al. Circulatory effects in man of nortriptyline, a tricyclic antidepressant drug. Pharmacol. Clin. 2, 68–71 (1970). https://doi.org/10.1007/BF00420708
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DOI: https://doi.org/10.1007/BF00420708