Advertisement

Trazodone-Induced Ventricular Arrhythmias: Fact or Artifact

  • Jonathan M. Himmelhoch
  • Kenneth Schechtman
  • Ralph Auchenbach

Abstract

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.

Keywords

Mitral Valve Prolapse Ventricular Premature Beat Lithium Salt Ventricular Ectopy Tive Heart Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    J. M. Himmelhoch, B. J. Symons, and J. F. Neil, Tranylcypromine use in “outrageous” circumstances, Abstract of the 12th C.I.N.P. COngress, Pro. Neuro-Psychopharmacol. (Suppl.) 174 (1980).Google Scholar
  2. 2.
    W. B. Abrams, M. C. Becker, and M. Shoskes, Amine oxidase inhibitors in the treatment of angina pectoris, in: “Coronary Heart Disease: The Seventh Hahnemann Symposium,” W. Likoff and J. H. Moyer, eds,, Grune and Stratton, New York (1963).Google Scholar
  3. 3.
    R. C. Veith, V. Bloom, R. Bielski, and R. O. Friedel, ECG effects of comparable plasma concentrations of desipramine and amitriptyline, J. Clin. Psychopharmacol. 2: 394–398 (1982).PubMedCrossRefGoogle Scholar
  4. 4.
    R. C. Veith, M. A. Raskin, J. H. Caldwell, R. F. Barnes, G. Gumbrecht, and J. L. Ritchie, Cardiovascular effects of tricyclic antidepressants in depressed patients with chronic heart disease, N. Engl. J. Med. 306: 954–959 (1982).PubMedCrossRefGoogle Scholar
  5. 5.
    A. H. Glassman and J. T. Bigger, Cardiovascular effects of therapeutic doses of tricyclic antidepressants: A review, Arch. Gen. Psychiatry 38: 815–820 (1981).PubMedGoogle Scholar
  6. 6.
    F. N. Johnson, “Handbook of Lithium Therapy,” MTP Press Limited, Lancaster, England (1980).Google Scholar
  7. 7.
    H. L. Tseng, Interstitial myocarditis probably related to lithium carbonate intoxication, Arch. Pathol. 92: 444–446 (1971).PubMedGoogle Scholar
  8. 8.
    T. N. Tangedahl and G. T. Grau, Myocardial irritability associated with lithium carbonate therapy, N. Engl. J. Med. 287: 867–869 (1972).PubMedCrossRefGoogle Scholar
  9. 9.
    D. Janoswky, G. Curtis, S. Zisook, K. Kuhn, K. Resovksy, and M. Le Winter, Ventricular arrhythmias possibly aggravated by trazodone, Am. J. Psychiatry 140: 796–797 (1983).Google Scholar
  10. 10.
    J. Morganroth, E. L. Michelson, L.N. Horowitz, M. E. Josephson, A. S. Pearlman, and W. B. Dunkman, Limitations of routine long-term electrocardiographic monitoring to assess ventricular ectopic frequency, Circulation 58: 3 (1978).Google Scholar
  11. 11.
    V. Velebit, P. Podrid, B. Lown, B. Cohen, and T. Graboys, Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs, Circulation 65: 886–894 (1982).PubMedCrossRefGoogle Scholar
  12. 12.
    E. G. Giardina and J. T. Bigger, Antiarrhythmic effect of imipramine hydrochloride in patients with ventricular premature complexes without psychological depression, Am. J. Cardiology 50: 172–179 (1982).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1985

Authors and Affiliations

  • Jonathan M. Himmelhoch
    • 1
  • Kenneth Schechtman
    • 2
  • Ralph Auchenbach
    • 1
  1. 1.School of Medicine, Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of PittsburghPittsburghUSA
  2. 2.School of Medicine, Department of BiostatisticsWashington UniversitySt. LouisUSA

Personalised recommendations