The cardiovascular effects of antidepressants

Warrington, S. J.; Padgham, C.; Lader, Malcolm

doi:10.1017/s0264180100000709

Cited by 39 publications

(13 citation statements)

References 281 publications

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“…No epileptic fits were reported or observed and this is consistent with Preskorn and Fast (1992) who reported a 0.4 per cent risk of seizures in carefully monitored patients on TCAs. ECG abnormalities indicative of delayed intraven-tricular conduction (Warrington et a[., 1989) were detected in five patients but all remained asymptomatic. Epileptic fits and malignant arrhythmias might have appeared in a larger series of patients.…”

Section: Relationship Between Plasma Concentration and Toxicitymentioning

confidence: 94%

High dose tertiary amine tricyclic antidepressants in the treatment of severe refractory depression: The central role of plasma concentration estimations

Hodgkiss

McCarthy

Sulke

et al. 1995

Human Psychopharmacology

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The relationships between dosage, plasma concentration, antidepressant response and toxicity were investigated in 24 highly selected patients with severe, refractory major depression who were prescribed amitriptyline, clomipramine or dothiepin at high dosage (15C-525 mg/day), usually in combination with lithium or other psychotropics. Of serious adverse effects 83 per cent were encountered when tricyclic antidepressant (TCA) plasma concentrations exceeded 400 mcg/l. Therapeutic drug monitoring of high dose TCAs is useful in minimizing the risk of toxicity and in revealing poor compliance, undertreatment and pharmacokinetic interactions which can mitigate against drug efficacy. The value of carbamazepine in the management of refractory depression in the context of unipolar affective disorder is put into question.

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Section: Relationship Between Plasma Concentration and Toxicitymentioning

confidence: 94%

High dose tertiary amine tricyclic antidepressants in the treatment of severe refractory depression: The central role of plasma concentration estimations

Hodgkiss

McCarthy

Sulke

et al. 1995

Human Psychopharmacology

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show abstract

“…Small-scale randomized controlled trials suggest that bupropion appears safe for most cardiac patients [31], although it may exacerbate baseline hypertension in a minority of patients [32]. Finally, monoamine oxidase inhibitors (MAOIs) have been associated with orthostatic hypotension at therapeutic doses and with hyperadrenergic crises in overdose, or with amine-containing foods or sympathomimetic medications [33]. These effects, in combination with the need for dietary and medication restrictions, relegate them to third-line status in this population.…”

Section: Other Depression Treatmentsmentioning

confidence: 99%

The impact of mental illness on cardiac outcomes: A review for the cardiologist

Sowden

Huffman

2009

International Journal of Cardiology

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“…Echoing this latter view, Last and Francis (1988) argue that the advantages of using imipramine, an antidepressant that can reduce panic attacks, as an adjunct to behaviour therapies are extraordinarily clear. Such drugs, however, may demonstrate unpleasant side effects such as feelings of nausea, weight loss, and allergic reactions, and are very toxic in overdose (Warrington, Padgham, & Lader, 1989). In rare cases there may be damage to the heart (King et al, 1995 ;Waters, 1990).…”

Section: Family Therapymentioning

confidence: 99%

Practitioner Review: School Refusal: Issues of Conceptualisation, Assessment, and Treatment

Elliott

1999

Child Psychology Psychiatry

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Developments in the assessment and treatment of school refusal have often been hampered by a failure to recognise its essentially heterogeneous nature. This paper provides a review of major conceptual complexities that have helped to undermine developments in clinical practice. In particular, it considers the distinction between school refusal and truancy, and school phobia and separation anxiety. Common approaches to the assessment and treatment of school refusal are outlined. Although behavioural and cognitive behavioural approaches are now widely accepted as central to treatment, it is increasingly recognised that individually tailored programmes, utilising a range of approaches, are most likely to prove successful. An approach focusing upon the functions, rather than the symptoms, of school refusal is advocated as having most promise for assessment and the subsequent formulation of individual prescriptive treatment.

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The cardiovascular effects of antidepressants

Cited by 39 publications

References 281 publications

High dose tertiary amine tricyclic antidepressants in the treatment of severe refractory depression: The central role of plasma concentration estimations

High dose tertiary amine tricyclic antidepressants in the treatment of severe refractory depression: The central role of plasma concentration estimations

The impact of mental illness on cardiac outcomes: A review for the cardiologist

Practitioner Review: School Refusal: Issues of Conceptualisation, Assessment, and Treatment

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