Antidepressants and heart disease.

When taken in overdosage tricyclic antidepressant drugs may be cardiotoxic.I 2 The most common findings are tachycardia and hypotension, but cardiac arrhythmias and abnormalities in cardiac conduction are also important. This reputation of tricyclic antidepressants for cardiotoxicity was enhanced by a series of papers from Aberdeen linking the therapeutic use of amitriptyline with sudden cardiac death, especially in patients with pre-existing cardiac disease.3-5 Though the Boston Collaborative Drug Surveillance Program could find no evidence of such an association,6 the problem has continued to trouble physicians and has led to the introduction of antidepressants that may be less cardiotoxic than amitriptyline.