Journal ArticleDOI
Cardiovascular Effects of Therapeutic Doses of Tricyclic Antidepressants: A Review
Glassman Ah,Bigger Jt +1 more
TLDR
Overdose of tricyclic antidepressants (TCAs) leave no doubt that TCA drugs at high concentrations have serious cardiac effects, but recent prospective, plasma-level-controlled studies have improved understanding of these drugs and proved assumptions to be inaccurate.Abstract:
• Overdoses of tricyclic antidepressants (TCAs) leave no doubt that TCA drugs at high concentrations have serious cardiac effects. It has been assumed that, to a lesser extent, these effects would occur at usual therapeutic concentration. Recent prospective, plasma-level-controlled studies have improved our understanding of these drugs and proved these assumptions to be inaccurate. The most common serious cardiovascular complication of most tricyclic drugs is orthostatic hypotension. Tricyclic antidepressants are essentially free of any other serious adverse effects in depressed patients without cardiovascular disease. In patients with preexisting bundlebranch disease, there is a risk of heart block. On the other hand, patients with ventricular arrhythmias are likely to have their arrhythmias improve with TCA therapy. Finally, therapeutic doses of TCA have little adverse effect on left ventricular performance. As a result, TCA drugs can often be used to benefit depressed patients with overt heart disease.read more
Citations
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Journal ArticleDOI
H1-receptor antagonists. Comparative tolerability and safety.
TL;DR: A benefit-risk ratio or therapeutic index should be developed for each medication in this class of H1-antagonists, and the magnitude of the beneficial effects should be related to the severity of the unwanted effects, especially in the CNS and cardiovascular system.
Journal ArticleDOI
Antipsychotic drugs : Prolonged QTc interval, torsade de pointes, and sudden death
TL;DR: Although pimozide, sertindole, droperidol, and haloperidol have been documented to cause torsade de pointes and sudden death, the most marked risk is with thioridazine, and only widespread use will prove if ziprasidone is entirely safe.
Journal ArticleDOI
Antidepressants and the risk of falls among nursing home residents.
TL;DR: There was little difference in rates of falls between those treated with tricyclic antidepressants and those treating with selective serotonin-reuptake inhibitors, and the preferential use of the newer antidepressants is unlikely to reduce the higher rate of falls among nursing home residents taking antidepressants.
Journal ArticleDOI
Excess risk of myocardial infarction in patients treated with antidepressant medications: association with use of tricyclic agents∗
TL;DR: The association between use of tricyclic antidepressants, but not SSRIs, with an increased risk of myocardial infarction in patients suggests that an earlier report that there was no difference in risk between the antidepressant classes, based on short-term studies, may not apply to long-term adverse cardiovascular outcomes.
Journal ArticleDOI
A controlled trial of antidepressants in patients with Parkinson disease and depression
Matthew Menza,Roseanne D. Dobkin,Humberto Marin,Margery H. Mark,Michael A. Gara,Steven Buyske,Karina L. Bienfait,Allison Dicke +7 more
TL;DR: The trial suggests that depression in patients with PD is responsive to treatment and raises questions about the relative efficacy of dual reuptake inhibitors and selective serotonin reuptakes inhibitors.
References
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Catheter Technique for Recording His Bundle Activity in Man
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Journal ArticleDOI
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TL;DR: Affinities of tricyclic drugs for alpha-noradrenergic receptor sites in the brain correlate well with the capacity of these agents to relieve psychomotor agitation and to induce sedation and hypotension; these affinities also correlate inversely with tendencies to elicit psychom motor activation.
Journal ArticleDOI
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TL;DR: There was a statistically and clinically significant relationship between plasma levels and response and this relationship existed across the entire sample, and was accentuated when the bipolar and unipolar nondelusional populations were examined.
Journal ArticleDOI
Sick Sinus Syndrome
J T Bigger,J A Reiffel +1 more
TL;DR: The sick sinus syndrome includes symptoms and signs related to sinus node dysfunction, which can be caused by intrinsic abnormal impulse formation and/or propagation from the sinus nodes or, in some cases, by extrinsic reversible causes.