The cardiovascular effects of cianopramine and amitriptyline in depressed patients

Abstract

The cardiovascular effects of cianopramine and amitriptyline were investigated in 27 depressed patients. Cianopramine (12 patients) increased QS2I (p<0.05) and LVETI (p<0.02) at 4 weeks. It tended to decrease PEP/LVET. On the ECG it decreased T wave amplitude at both 2 and 4 weeks (p<0.05), and decreased erect systolic blood pressure at 2 weeks (p<0.01) and 4 weeks (p<0.05). These changes suggest decrease in afterload, probably through peripheral alpha-receptor blockade. Amitriptyline (15 patients) increased PEP/LVET at 2 and 4 weeks (p<0.05) and decreased % diastole at 2 and 4 weeks (p<0.001). On the ECG it decreased T-wave amplitude (p<0.01 at 2 weeks and p<0.05 at 4 weeks) and prolonged the QT(c) interval at 2 weeks (p<0.01) and 4 weeks (p<0.02). Heart rate also increased at both 2 and 4 weeks (p<0.01). It also decreased erect systolic blood pressure at week 4 (p<0.05). These results suggest that amitriptyline may aggravate ischaemic heart disease and be arrhythmogenic. Cianopramine is to be preferred in depressed patients who have heart disease.