Abstract
In the preceding chapter, Dr Burrows and his colleagues have reviewed the usual cardiovascular effects of tricyclic antidepressants (TCA). We would like now to focus in greater detail on several cardiovascular effects which are clinically important but have, until recently, been poorly understood. The specific effects we will review are the antiarrhythmic properties of tricyclic compounds, their effect on left ventricular performance, and their propensity to produce orthostatic hypotension. We will discuss why these effects have been poorly understood for so long and will review the implications of these effects on the clinical use of TCA and on our understanding of the basic pharmacology of these drugs.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bigger, J. T., Giardina, E. G., Perel, J. M., Kantor, S. and Glassman, A. (1977).Cardiac antiarrhythmic effect of imipramine hydrochloride. New Engl. J. Med.,296, 206–8
Briley, M. S., Langer, S. Z., Raisman, R., Sechter, D. and Zarifian, E. (1980). Tritiated imipramine binding sites are decreased in platelets of untreated depressed patients. Science, N. Y., 209, 303–5
Burckhardt, D., Raeder, E., Müller, V., Imhof, P. and Neubauer, H. (1978). Cardiovascular effects of tricyclic and tetracyclic antidepressants. J. Am. med. Assoc., 239, 213–6
Burrows, G. D., Vohra, J., Hunt, D., Sloman, J. G., Scoggins, B. A. and Davies, B. (1976). Cardiac effects of different tricyclic antidepressant drugs. Br. J. Psychiat., 129, 335–41
Giardina, E. G., Bigger, J. T., Jr, Glassman, A. H., Perel, J. M. and Kantor, S. J. (1979). The electrocardiographic and antiarrhythmic effects of imipramine hydrochloride at therapeutic plasma concentrations. Circulation, 60, 1045–52
Giardina, E. G. et al., (1981). Ann. Cardiol., submitted
Glassman, A. H., Bigger, J. T., Jr, Giardina, E. V., Kantor, S. J., Perel, J. M. and Davies, M. (1979). Clinical characteristics of imipramine-induced orthostatic hypotension. Lancet, i, 468–72
Hoffman, B. F. and Bigger, J. T., Jr (1971). Antiarrhythmic drugs. In Drill’s Pharmacology in Medicine, 4th edn (ed. J. R. DiPalma), McGraw-Hill, New York, pp. 824–52
Kantor, S. J., Bigger, J. T., Jr, Glassman, A. H. and Macken, D. L. (1975). Imipramine-induced heart block: a longitudinal case study. J. Am. med. Assoc., 231, 1364–6
Lecrubier, Y., Allilaire, J. F., Puech, A., Simon, P. and Des Lauriers, A. (1980). Yohimbine antagonism of clomipramine-induced orthostatic hypotension. In Abstracts of the 12th CINP Congress, Supplement to Progress in Neuro-Psychopharmacology, An International Research and Review Journal, Pergamon Press, New York, 1980, p. 220
Marshall, R. C, Berger, H. J., Costin, J. C, Freedman, G. S., Wolberg, J., Cohen, L. S., Gottschalk, A. and Zaret, B. L. (1977). Assessment of cardiac performance with quantitative radionuclide angiocardiography. Circulation, 56, 820–9
Moccetti, T., Lichtlen, P., Albert, H., Meier, E. and Imbach, P. (1971). Kardiotoxizität der trizyklischen Antidepressiva. Schweiz, med. Wschr., 101,1
Müller, V. and Burckhardt, D. (1974). Die Wirkung tri- und tetrazyklischer Antidepressiva auf Herz und Kreislauf. Schweiz, med. Wschr., 104, 1911–3
Rawling, D. A. and Fozzard, H. A. (1979). Effects of imipramine on cellular electrophysiological properties of cardiac Purkinje fibers. J. Pharmac exp. Ther., 209, 371–5
Roose, S., Glassman, A. H., Siris, S. and Bruno, R. (1980). TCA-induced postural hypotension; comparative studies. Scientific Proceedings of Supplemental Program, American Psychiatric Association, May, 1980
Taylor, D. J. and Braithwaite, R. A. (1978). Cardiac effects of tricyclic antidepressant medication: a preliminary study of nortriptyline. Br. Heart J., 40, 1005–9
U’Prichard, D. C, Greenberg, D. A., Sheehan, P. P. and Snyder, S. H. (1978). Tricyclic antidepressants: therapeutic properties and affinity for alpha-noradrenergic receptor binding sites in the brain. Science, N. Y., 199, 197–8
Vohra, J., Burrows, G. D., Hunt, D. and Sloman, G. (1975a). The effect of toxic and therapeutic doses of tricyclic antidepressant drugs on intracardiac conduction. Eur. J. Cardiol, 3, 219–27
Vohra, J., Burrows, G. D. and Sloman, G. (1975b). Assessment of cardiovascular side effects of therapeutic doses of tricyclic anti-depressant drugs. Aust. N.Z. J. Med., 5, 7–11
Weld, F. M. and Bigger, J. T., Jr (1980). Electrophysiological effects of imipramine on ovine cardiac Purkinje and ventricular muscle fibers. Circulation Res., 46, 167–75
Wilkerson, R. D. (1978). Antiarrhythmic effects of tricyclic antidepressant drugs in ouabain-induced arrhythmias in the dog. J. Pharmac. exp. Ther., 205, 666–74
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Copyright information
© 1981 The contributors
About this chapter
Cite this chapter
Glassman, A.H., Walsh, B.T., Roose, S.P. (1981). Cardiovascular effects of the tricyclic antidepressants: implications for new research. In: Usdin, E., Dahl, S.G., Gram, L.F., Lingjærde, O. (eds) Clinical Pharmacology in Psychiatry. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-05929-4_30
Download citation
DOI: https://doi.org/10.1007/978-1-349-05929-4_30
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-349-05931-7
Online ISBN: 978-1-349-05929-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)