Cardiovascular effects of imipramine and nortriptyline in elderly patients
- 1 September 1981
- journal article
- research article
- Published by Springer Nature in Psychopharmacology
- Vol. 74 (4), 360-364
- https://doi.org/10.1007/bf00432748
Abstract
Cardiovascular effects in elderly depressed patients (age 62–78 years) treated with imipramine (N=11) or nortriptyline (N=10) were recorded by monitoring of heart rate, blood pressure, systolic time intervals, standard ECG and 24-h ECG. The two drugs exhibited distinctly different cardiovascular reactions. The use of imipramine was severely limited by orthostatic hypotension occurring at subtherapeutic plasma levels, which resulted in falls with fracture in two patients. In contrast, nortriptyline at therapeutic drug levels did not significantly influence orthostatic blood pressure regulation. Nortriptyline caused moderate changes in systolic time intervals, indicating impairment in myocardial contractility. This effect was not seen with imipramine, but a majority of the patients did not reach therapeutic plasma levels because of the blood pressure reactions. Neither imipramine nor nortriptyline induced changes in cardiac conduction time measurements or arrhythmias. In addition to the blood pressure reactions, the use of imipramine was complicated by dose dependent kinetics.Keywords
This publication has 28 references indexed in Scilit:
- Dose-dependent kinetics of imipramine in elderly patientsPsychopharmacology, 1981
- The electrocardiographic and antiarrhythmic effects of imipramine hydrochloride at therapeutic plasma concentrations.Circulation, 1979
- Cardiovascular effects of amitriptyline, mianserin, zimelidine and nomifensine in depressed patientsPublished by Oxford University Press (OUP) ,1979
- CLINICAL CHARACTERISTICS OF IMIPRAMINE-INDUCED ORTHOSTATIC HYPOTENSIONThe Lancet, 1979
- High-performance thin-layer chromatographic determination of psychopharmacologic agents in blood serumJournal of Chromatography A, 1977
- Plasma Level Monitoring of Tricyclic Antidepressant TherapyClinical Pharmacokinetics, 1977
- Steady-state kinetics of imipramine in patientsPsychopharmacology, 1977
- Studies in the Classification of Affective DisordersThe British Journal of Psychiatry, 1972
- Physiologic Responses as Prognostic Guides in the Use of Antidepressant DrugsAmerican Journal of Psychiatry, 1968
- Development of a Rating Scale for Primary Depressive IllnessBritish Journal of Social and Clinical Psychology, 1967