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Electrocardiogram Changes and Therapeutic Desipramine and 2-Hydroxy-Desipramine Concentrations in Elderly Depressives

Published online by Cambridge University Press:  29 January 2018

S. P. Kutcher ,
K. Reid ,
J. D. Dubbin  and
K. I. Shulman
S. P. Kutcher*
Affiliation:
M.R.C. Brain Metabolism Unit, Royal Edinburgh Hospital, Edinburgh, Scotland EH19 5HF
K. Reid
Affiliation:
Queen Street Mental Health Centre, 1001 Queen St. W., Toronto, Ontario, Canada
J. D. Dubbin
Affiliation:
Sunnybrook Medical Centre
K. I. Shulman
Affiliation:
Coordinator Division of Geriatric Psychiatry, Sunnybrook Medical Centre
*
∗Correspondence
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Abstract

ECG parameters in elderly depressed in-patients were assessed during routine despramine treatment. Significant changes (prolonged PR and PRS intervals and a decreased QTc interval) were found, related only to steady state concentrations of desipramine's major metabolite—2-hydroxy-desipramine. Potentially clinically significant changes developed in 40% of the patients. All serum drug concentrations were within therapeutic limits. Previous assurances about despiramines's cardiac safety in the elderly may need to be re-evaluated.

Type
Papers
Information
The British Journal of Psychiatry , Volume 148 , Issue 6 , June 1986 , pp. 676 - 679
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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Footnotes

∗

Present Address: University of Toronto, Department of Psychiatry, Sunnybrook Medical Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada

References

Bianchetti, G., Bonaccorsi, A., Chiodaroli, A., Franco, R., Garattini, S., Gomeni, R. & Morseli, P. L. (1977) Plasma concentrations and cardiotonic effects of desipramine and protriptyline in the rat. British Journal of Pharmacology, 60, 11–19.CrossRefGoogle Scholar
Bock, J. L., Nelson, J. C. Gray, S. G. & Jatlow, P. I. (1983) Desipramine hydroxylation and antipsychotic drugs. Clinical Pharmacology and Therapeutics, 33, 322–327.CrossRefGoogle ScholarPubMed
Boston Collaborative Drug Surveillance Program (1972) Adverse reactions to the tricyuclic-antidepressant drugs. Lancet, i, 529–531.Google Scholar
Cassem, N. (1982) Cardiovascular effects of antidepressants. Journal of Clinical Psychiatry, 43, 22–28.Google ScholarPubMed
Cutler, N. R., Zavadil, A. P., Linnoila, M., Scheinin, M., Rudorfer, M. V. & Potter, W. Z. (1984) Effects of chronic desipramine on plasma norepinephrine concentrations and cardiovascular parameters in elderly depressed women: A Preliminary Report. Biological Psychiatry, 19, 549–556.Google ScholarPubMed
De Vane, C. L., Savett, M. & Jusco, W. J. (1981) Desipramine and 2-hydroxy-desipramine pharmacokinetics in normal volunteers. European Journal of Clinical Pharmacology, 19, 61–64.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) The “mini mental state”: A practical method for grading the cognitive states of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fowler, N. O., McCall, D., Chou, T. et al, (1976) Electrocardiographic changes and cardiac arrhythmias in patients receiving psychotropic drugs. American Journal of Cardiology, 37, 223–230.CrossRefGoogle ScholarPubMed
Glassman, A. H. & Bigger, J. T. (1981) Cardiovascular effects of therapeutic doses of tricyclic antidepressants. Archives of General Psychiatry, 38, 815–820.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960) A rating for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Hollister, L. (1979 Psychotherapeutic drugs. In Neuropsychiatrie Side Effects of Drugs in the Elderly (ed. Levenson, A). New York: Raven Press.Google Scholar
Jandhyala, B. S., Steenberg, M. L., Perel, J. M., Manian, A. A. & Buckley, J. P. (1977) Effects of several tricyclic antidepressants on the hemodynamics and myocardial contractility of the anesthetized dogs. European Journal of Pharmacology, 42, 403–410.CrossRefGoogle ScholarPubMed
Javaid, J. I., Perel, J. M. & Davis, J. M. (1979) Inhibition of biogenic amines uptake by Imipramine, desipramime 2 OH-imipramine and 2 OH-desipramine in rat brain. Life Science, 24, 21–28.CrossRefGoogle ScholarPubMed
Jefferson, J. W. (1975) A review of the cardiovascular effects and toxicity of tricyclic antidepressants. Psychosomatic Medicine, 37, 160–179.CrossRefGoogle ScholarPubMed
Nelson, C. J., Bock, J. L. & Jatlow, M. D. (1983) Clinical implications of 2-hydroxydesipramine plasma concentrations. Clinical Pharmacology and Therapeutics, 33, 183–189.CrossRefGoogle ScholarPubMed
Nelson, C. J., Jatlow, P., Bock, J., et al. (1982) Major adverse reactions during despramine treatment. Archives of General Psychiatry, 39, 1055–1061.CrossRefGoogle Scholar
Nelson, C. J., Jatlow, P. I. & Quinlan, D. M. (1982) Desipramine plasma concentration and antidepressant response. Archives of General Psychiatry, 39, 1419–1422.CrossRefGoogle ScholarPubMed
Nies, A., Robinson, D. S., Matthew, J., Freidman, J., Green, R., Cooper, T. B., Ravaris, C. L. & Ives, J. O. (1977) Relationship between age and tricyclic antidepressant plasma levels. American Journal of Psychiatry, 134, 790–793.Google ScholarPubMed
Potter, W. Z., Calil, H. M., Sutfin, T. A., Zavadil, A. P., Jusko, J. W. & Rapoport, J. (1982) Active metabolites of imipramine and desipramine in man. Clinical Pharmacology and Therapeutics, 31, 393–401.CrossRefGoogle ScholarPubMed
Potter, W. Z., Calil, H. M., Manian, A. A., Zavadil, A. P. & Woodwin, F. K. (1979) Hydroxylated metabolites of tricyclic antidepressants; preclinical assessment of activity. Biological Psychiatry, 14, 601–614.Google ScholarPubMed
Rudorfer, M. V. & Young, R. C. (1980) Desipramine: cardiovascular effects and plasma levels. American Journal of Psychiatry, 137, 984.Google ScholarPubMed
Salzman, C. (1982) A primer on geriatric psychopharmacology, American Journal of Psychiatry, 139, 67–74.Google ScholarPubMed
Salzman, C. (1979) Update on geriatric psychopharmacology. Geriatrics, 16, 87–90.Google Scholar
Tamaxgo, J., Rodriguez, S. & Garcia de Jalon, P. (1979) Electrophysiological effects of desipramine on guinea pig papillar muscles. European Journal of Pharmacology, 55, 171–179.CrossRefGoogle Scholar
Veith, R. C., Friedel, R. O. Bloom, V. & Bielskil, R. (1980) Electrocardiogram changes and plasma desipramine levels during treatment of depression. Clinical Pharmacology and Therapeutics, 27, 796–802.CrossRefGoogle ScholarPubMed
Vestall, R. E. Wood, A. J. & Shand, O. G. (1979) Reduced beta-adrenoceptor sensitivity in the elderly. Clinical Pharmacology and Therapeutics, 26, 181–186.CrossRefGoogle Scholar
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