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Mianserin, maprotiline and intracardiac conduction
British Journal of Clinical Pharmacology
|January 1, 1983
Summary
Mianserin showed no cardiac effects in patients with depression. Maprotiline, however, increased heart rate and PR interval, indicating anticholinergic activity and intracardiac conduction effects.
Area of Science:
- Clinical Pharmacology
- Cardiology
- Psychiatry
Background:
- Antidepressant medications can have varying cardiovascular effects.
- Mianserin and maprotiline are commonly prescribed for primary depressive illness.
- Understanding their cardiac safety profile is crucial for patient management.
Purpose of the Study:
- To evaluate the cardiac effects of mianserin and maprotiline in patients with primary depressive illness.
- To compare electrocardiogram (ECG) parameters between mianserin, maprotiline, and placebo groups.
- To investigate potential correlations between plasma drug concentrations and ECG changes.
Main Methods:
- A placebo-controlled trial involving 35 patients with primary depressive illness.
- High-speed surface electrocardiograms recorded at baseline and after four weeks of treatment.
- Blind measurements of ECG intervals (RR, PR, QT), QRS width, T wave height, and cardiac arrhythmias.
- Comparison of ECG parameters with plasma drug concentrations.
Main Results:
- Maprotiline group showed a significant increase in heart rate and PR interval, and a decrease in corrected QT (QTc) interval.
- Mianserin group exhibited no significant changes in cardiac parameters compared to placebo.
- Only one patient in the maprotiline group experienced a cardiac arrhythmia.
- No significant correlation was found between ECG parameters and plasma drug levels.
Conclusions:
- Mianserin demonstrates a lack of significant cardiac effects.
- Maprotiline exhibits anticholinergic activity and affects intracardiac conduction.
- These findings highlight differential cardiovascular safety profiles of these two antidepressants.