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Comparative effects of fluoxetine and amitriptyline on cardiac function
J W Upward1, J G Edwards, A Goldie
1Clinical Pharmacology Group, Southampton General Hospital.
British Journal of Clinical Pharmacology
|October 1, 1988
Summary
Fluoxetine did not affect electrocardiogram (ECG) or systolic time intervals (STIs) in depressed patients. High-dose amitriptyline altered ECG intervals but did not significantly change STIs, suggesting differing cardiac safety profiles.
Area of Science:
- Cardiology
- Pharmacology
- Psychiatry
Background:
- Antidepressant medications like fluoxetine and amitriptyline are widely prescribed.
- Understanding their cardiovascular effects is crucial for patient safety.
Purpose of the Study:
- To compare the effects of fluoxetine and amitriptyline on electrocardiogram (ECG) and systolic time intervals (STIs).
- To assess the cardiac safety profile of these two common antidepressants.
Main Methods:
- A double-blind, parallel-group study was conducted.
- Patients received placebo, followed by fluoxetine (40-80 mg/day) or amitriptyline (100-200 mg/day) for several weeks.
- Electrocardiograms (ECG) and systolic time intervals (STIs) were measured at various time points.
Main Results:
- Fluoxetine showed no significant impact on ECG or STIs at any dosage.
- Amitriptyline (150-200 mg/day) significantly shortened sinus cycle length (12%), prolonged PR interval (8%), and increased QRS duration (10%).
- Amitriptyline did not significantly alter systolic time intervals (STIs).
Conclusions:
- Fluoxetine appears to have a neutral cardiovascular effect regarding ECG and STIs.
- High-dose amitriptyline demonstrates significant but potentially manageable ECG changes.
- The findings suggest distinct cardiac safety profiles for fluoxetine and amitriptyline, particularly at therapeutic doses.