Cardiovascular effects of tricyclic and tetracyclic antidepressants

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Abstract
Cardiovascular effects of therapetuic doses of tricyclic or tetracyclic antidepressants (TCA) were examined in 66 patients. After 3 wk of therapy, heart rate and PR interval were increased (P < .02, P < .05), while prolongation of QTc time and the QRS interval did not reach significant levels. A significant flattening of T waves (P < .05) was observed, which was not associated with changes in serum K level. These changes were reversible after treatment was discontinued. When therapy was maintained for 13 mo., only heart rate continued to be increased, whereas all other ECG vales had returned to normal. TCA therapy led to a significant prolongation of the preejection period (P < .01) and slight shortening of the left ventricular ejection time, indicating a decrease in myocardial contractility. there was no difference of effects on values studied between tricyclic and tetracyclic antidepressants.