The effect of nortriptyline in elderly patients with cardiac conduction disease
Dietch, J.T.; Fine, M.
Journal of Clinical Psychiatry 51(2): 65-67
1990
ISSN/ISBN: 0160-6689 PMID: 2298706 Document Number: 355246
Ten depressed, elderly patients with cardiac conduction abnormalities were given therapeutic doses of nortriptyline. Serial ECGs revealed no clinically significant adverse cardiac changes. These data, added to the findings of previous research, suggest that tricyclic antidepressants (TCAs) present little risk in patients with first degree antrioventricular block or hemiblock. Patients with bundle-branch block and bifascicular block are at greater risk of adverse cardiac sequelae but can be treated with TCAs. To maximize safety, the authors recommend monitoring serial ECGs and plasma TCA levels.