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Cardiac Complications of Tricyclic Antidepressant Therapy

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▸Requests for reprints should be addressed to Redford B. Williams, M.D., Section of Psychobiology, National Institute of Mental Health, National Institutes of Health, Bethesda, Md. 20014

New Haven and West Haven, Connecticut

Ann Intern Med. 1971;74(3):395-398. doi:10.7326/0003-4819-74-3-395
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Two similar cases of unresponsive cardiac standstill secondary to toxicity of tricyclic antidepressants are reported. One is a case of deliberate overdose, and the other represents toxicity of therapeutic doses in a patient "pretreated" with a catecholamine depleting agent (guanethidine). Tricyclicamine antidepressants block the uptake of catecholamines by the heart, allowing enzymatic degradation and further catecholamine depletion. This group of antidepressants should therefore be contraindicated in patients receiving drugs that deplete cardiac catecholamines.





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