Document Detail

Cardiovascular effects of imipramine and bupropion in depressed patients with congestive heart failure.
MedLine Citation:
PMID:  3114333     Owner:  NLM     Status:  MEDLINE    
There has been a long-standing concern over the cardiovascular effects of tricyclic antidepressants, particularly in patients with preexisiting cardiac disease. Recent studies have demonstrated that imipramine causes no deleterious effect on ejection fraction as determined by radionuclide angiography in patients with impaired left ventricular function (LVF). However, the high rate of severe orthostatic hypotension induced by imipramine makes use of the drug problematic in these patients. Bupropion is a new antidepressant of the aminoketone class which is structurally unrelated to the tricyclics and which is relatively free of cardiac side effects in healthy depressed patients. We compared imipramine and bupropion in 10 depressed patients with impaired LVF in a random, double-blind crossover study. Neither imipramine nor bupropion adversely affected ejection fraction or other indices of LVF. However, as previously reported, severe orthostatic hypotension requiring discontinuation of drug developed in 50% of patients on imipramine. This difficulty did not occur with bupropion. From a cardiac perspective, bupropion may offer a safe alternative to imipramine in depressed patients with congestive heart failure.
S P Roose; A H Glassman; E G Giardina; L L Johnson; B T Walsh; J T Bigger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  7     ISSN:  0271-0749     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  1987 Aug 
Date Detail:
Created Date:  1987-10-19     Completed Date:  1987-10-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  247-51     Citation Subset:  IM    
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MeSH Terms
Antidepressive Agents / adverse effects*,  therapeutic use
Blood Pressure / drug effects
Clinical Trials as Topic
Depressive Disorder / complications*,  drug therapy
Double-Blind Method
Heart Failure / complications*
Hemodynamics / drug effects*
Imipramine / adverse effects*,  therapeutic use
Middle Aged
Propiophenones / adverse effects*,  therapeutic use
Random Allocation
Reg. No./Substance:
0/Antidepressive Agents; 0/Propiophenones; 34841-39-9/Bupropion; 50-49-7/Imipramine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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