Document Detail


Risks of antidepressants in the elderly: tricyclic antidepressants and arrhythmia-revising risks.
MedLine Citation:
PMID:  8020766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Unexpected events have occurred in cardiology over the last 4 years. A study by the Heart and Lung Institute of the National Institute of Health in the mid-1980s showed to great surprise that class I antiarrhythmic drugs given to patients with ventricular arrhythmias following myocardial infarction, instead of preventing deaths, actually increased the number of patients dying. Since then, a series of studies has consistently confirmed this original observation. The problem for psychiatry is that the tricyclic antidepressant (TCA) drugs are also class I antiarrhythmics. There is every reason to believe that a similar increased risk of death would exist with the TCAs. It is, therefore, important for psychiatrists to understand the cause and magnitude of this excess in deaths. Evidence to date would suggest that all class I compounds, despite being powerful antiarrhythmics under usual physiological conditions, become proarrhythmic under anoxic conditions. Such conditions would exist in ischaemic heart disease during angina and, particularly, myocardial infarction. How this might alter our use of TCAs and whether this happens with the selective serotonin reuptake inhibitors is discussed.
Authors:
A H Glassman; S P Roose
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Gerontology     Volume:  40 Suppl 1     ISSN:  0304-324X     ISO Abbreviation:  Gerontology     Publication Date:  1994  
Date Detail:
Created Date:  1994-08-04     Completed Date:  1994-08-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7601655     Medline TA:  Gerontology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  15-20     Citation Subset:  IM    
Affiliation:
Department of Clinical Psychopharmacology, College of Physicians and Surgeons, Columbia University, New York, N.Y. 10032.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / complications
Antidepressive Agents, Tricyclic / adverse effects,  therapeutic use*
Arrhythmias, Cardiac / chemically induced*,  diagnosis,  drug therapy
Coronary Disease / complications
Depressive Disorder / drug therapy*,  psychology
Humans
Myocardial Infarction / complications
Risk Factors
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Tricyclic

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


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