Trazodone-Induced Ventricular Arrhythmias: Fact or Artifact
So it is that the cardiovascular side-effects of all the antidepressants have been exaggerated. First, the monoamine oxidase inhibitors (MAOI) became contraindicated for depressed, cardiac patients because of their food and drug interactions, even though in certain circumstances the MAOI’s lower blood pressure and increase coronary artery blood flow—pharmacologic characteristics that could prove most useful for certain compliant sub-groups of cardiac depressives.1,2 Next, data derived from animal studies and from cases of suicide or perisuicide committed by means of tri-tetracyclic overdose were used to overstate the cardiovascular dangers of this group of medications3,4,5.Then, lithium salts were implicated in cardio– pathology6,7,8, yet, there is still no absolute contraindication to their use in bipolar patients with heart disease. Recently, even trazodone, an antidepressant which came onto the market with a reputedly benign cardiovascular profile, has been reported as potentially cardiotoxic.9 In an anecdotal study, Janowsky has described two subjects (from a total group of 15) whose pre-existing ventricular arrhythmias were aggravated after beginning trazodone treatment for their depressions.
KeywordsDepression Lithium Hydrochloride Propranolol Digoxin
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