[The problem of side-effects: cardiotoxicity (author's transl)]

The cardiotoxicity of tricyclics is wellknown. The interpretations of such a mechanism are many: the tricyclic ring, the dimetilaminic group, the re-uptake NA mechanisms at myocardic level. A study was designed in order to answer the question. Four antidepressant drugs (a true quadricyclic: mianserin; a tricyclic with short later chain: amineptine; two tricyclic antidepressants with long chain: amitriptyline and chlorimipramine) were chosen in the double-blind cross-over study design in two different types of depression: anxious and retarded depression. A computerized cycloergometer test was performed at different times, together with ECG and depression evaluation. The patients with retarded depression were treated with amineptine (from 150 mg to 300 mg/day) and after a wash-out periods with chlorimipramine (150 mg/day). The patients with anxious depression were treated with mianserin (30-60 mg/day) for a fortnight and afterwards with amitriptyline (150 mg/day). The evaluation of the ergometric tests carried out at the fixed day have been carried out using the "Minnesota methodology". The results obtained show that the quadricyclic (mianserin) doesn't point out any cardiotoxicity. All tricyclics, especially amitriptyline, show cardiotoxicity signs.