Why the study?
Do tricyclic antidepressant drugs cause adverse cardiac conduction effects in depressed patients?
Do tricyclic antidepressant drugs cause adverse cardiac conduction effects in depressed patients?
Tricyclic antidepressants can cause significant increases in heart rate and atrioventricular conduction times, with distal conduction defects occurring frequently in overdosage and occasionally at therapeutic doses.
Supports ECG monitoring with TCAs; leaves open relative overdose safety of doxepin versus alternatives in contemporary use.
The effects of tricyclic antidepressants on the heart are reviewed. Statistically significant increases in heart rate and in atrioventricular conduction times were found following the administration of tricyclic drugs to 32 depressed patients. The method of His bundle electrocardiography was used to study atrioventricular conduction in ambulant patients and in patients admitted after an overdose of tricyclic antidepressant drugs. Distal conduction defects were frequently found in patients following tricyclic overdosage, but these were not seen with doxepin overdosage. Impaired distal conduction was also found in occasional patients on therapeutic doses of tricyclic drugs. Some animal experiments giving similar results to the above clinical findings are also described. The clinical implications of these findings are discussed.
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Burrows et al. (1976) studied this question.
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