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Titolo:
Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients
Autore:
de la Torre, BR; Dreher, J; Malevany, L; Bagli, M; Kolbinger, M; Omran, H; Luderitz, B; Rao, ML;
Indirizzi:
Univ Bonn, Dept Psychiat & Psychotherapy, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 hiat & Psychotherapy, D-5300 Bonn, Germany Univ Bonn, Dept Cardiol, D-5300 Bonn, Germany Univ Bonn Bonn Germany D-5300 v Bonn, Dept Cardiol, D-5300 Bonn, Germany
Titolo Testata:
THERAPEUTIC DRUG MONITORING
fascicolo: 4, volume: 23, anno: 2001,
pagine: 435 - 440
SICI:
0163-4356(200108)23:4<435:SLACEO>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTI-DEPRESSANTS; FLUOXETINE; FLUVOXAMINE; DESIPRAMINE; PAROXETINE; IMIPRAMINE; DISEASE; 2-HYDROXYDESIPRAMINE; CHROMATOGRAPHY; NORTRIPTYLINE;
Keywords:
tricyclic antidepressant drug; selective serotonin reuptake inhibitors; serum concentration; depression;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Rao, ML Univ Bonn, Dept Psychiat, Sigmund Freud Str 25, D-53105 Bonn, Germany Univ Bonn Sigmund Freud Str 25 Bonn Germany D-53105 Bonn, Germany
Citazione:
B.R. de la Torre et al., "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients", THER DRUG M, 23(4), 2001, pp. 435-440

Abstract

Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are used to treat depression. Whereas cardiovascular effects have occasionally been reported during controlled studies with SSRIs, TCA treatment poses a well-known problem in this respect. To investigate the putative correlation between antidepressant dose or serum levels and adverse effects, the authors devised a naturalistic study to evaluate the tricyclic antidepressants' and SSRIs' effect on the cardiovascular system. The authors also compared antidepressant serum levels to adverse effects. Inpatients treated with TCAs or SSRIs were included; an electrocardiogram (ECG) and a Schellong test were carried out on the day patients entered the hospital and during steady-state treatment with antidepressant drugs when blood was drawnfor therapeutic drug monitoring. The patient population consisted of 114 acutely depressed patients; 81 patients were treated with TCAs and 33 with SSRIs. The TCAs comprised amitriptyline (n = 43), clomipramine (n = 11), doxepin (n = 19) and imipramine (n = 8); the SSRIs comprised fluvoxamine (n = 14) and paroxetine (n = 19). In TCA-treated patients, the authors observed the same type of abnormalities in conduction and orthostatic hypotension ashad been observed earlier. The authors also observed cases of first-degreeatrioventricular block, prolonged QTc interval, and orthostatic hypotension in SSRI-treated patients. Thus SSRIs also appear to affect the cardiovascular system, which might pose a problem for patients with preexisting conduction disease. The authors observed a strong correlation between the decrease in systolic pressure and antidepressant serum concentration (except for clomipramine and paroxetine), suggesting that antidepressant serum level isa better correlate than dose.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 06:58:09