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A review of cyclic antidepressant-induced blood dyscrasias

G M Levin1, C L DeVane

  • 1College of Pharmacy, University of Florida, Gainesville 32610.

Insights

Tricyclic antidepressants can cause blood dyscrasias like agranulocytosis and eosinophilia. This review details associated symptoms, onset, and recovery times for various blood abnormalities.

Area of Science:

  • Pharmacology
  • Hematology
  • Toxicology

Background:

  • Tricyclic antidepressants (TCAs) are widely prescribed for depression.
  • TCAs share structural similarities with phenothiazines, known to cause blood dyscrasias.
  • Literature review to identify cases of blood dyscrasias linked to TCAs.

Observation:

  • MEDLINE database search using terms: blood, abnormalities, dyscrasias, antidepressants, agranulocytosis, eosinophilia.
  • Included human studies published in English, excluding letters to the editor with insufficient data.
  • Extracted data on drug, onset, recovery, and symptoms for each reported case.

Findings:

  • A comprehensive table details various blood dyscrasias associated with TCA use.
  • Specific data on onset, recovery timelines, and presenting symptoms are provided for each case.
  • Common symptoms across different blood dyscrasias are analyzed.

Implications:

  • Understanding the link between TCAs and blood dyscrasias is crucial for patient safety.
  • Structural similarities to phenothiazines may explain the hematological risks.
  • Recommendations for managing both blood dyscrasias and underlying depression are discussed.
Abstract

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