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Cardiovascular effects of fluoxetine in depressed patients with heart disease.
- Source :
-
The American journal of psychiatry [Am J Psychiatry] 1998 May; Vol. 155 (5), pp. 660-5. - Publication Year :
- 1998
-
Abstract
- Objective: The purpose of this study was to determine the cardiovascular effects of fluoxetine in depressed patients with cardiac disease.<br />Method: Twenty-seven depressed patients (26% of whom were female and whose average age was 73 years) who had congestive heart failure, conduction disease, and/or ventricular arrhythmia were studied in an open medication trial of fluoxetine, up to 60 mg/day, for 7 weeks. The main outcome measures were heart rate and rhythm measured by 24-hour ECG recordings, ejection fraction determined by radionuclide angiography, cardiac conduction intervals, and blood pressure. Baseline values were compared with those at weeks 2 and 7 of fluoxetine treatment. In 60 comparable patients, values of these same cardiovascular measures at baseline and after 3 weeks of treatment with a tricyclic antidepressant, nortriptyline, were also examined.<br />Results: Fluoxetine induced a statistically significant 6% decrease in heart rate, a 2% increase in supine systolic pressure, and a 7% increase in ejection fraction. There was no effect on cardiac conduction, ventricular arrhythmia, or orthostatic blood pressure. Overall, 4% of the fluoxetine patients had an adverse cardiovascular effect. In contrast, nortriptyline treatment caused a significant increase in heart rate and orthostatic hypotension, and 20% of the nortriptyline-treated patients had an adverse cardiovascular effect.<br />Conclusions: In depressed patients with heart disease, fluoxetine treatment was not associated with the cardiovascular effects documented for the tricyclic antidepressants or with significant adverse cardiac events. However, limited conclusions about fluoxetine's cardiovascular effects and safety can be drawn from this study of only 27 patients monitored for 7 weeks.
- Subjects :
- Adult
Aged
Antidepressive Agents, Tricyclic adverse effects
Antidepressive Agents, Tricyclic pharmacology
Antidepressive Agents, Tricyclic therapeutic use
Blood Pressure drug effects
Comorbidity
Drug Administration Schedule
Electrocardiography drug effects
Female
Fluoxetine adverse effects
Fluoxetine pharmacology
Heart Rate drug effects
Humans
Hypotension, Orthostatic chemically induced
Male
Nortriptyline adverse effects
Nortriptyline pharmacology
Nortriptyline therapeutic use
Selective Serotonin Reuptake Inhibitors adverse effects
Selective Serotonin Reuptake Inhibitors pharmacology
Stroke Volume drug effects
Depressive Disorder drug therapy
Depressive Disorder epidemiology
Fluoxetine therapeutic use
Heart Diseases epidemiology
Hemodynamics drug effects
Selective Serotonin Reuptake Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0002-953X
- Volume :
- 155
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 9585718
- Full Text :
- https://doi.org/10.1176/ajp.155.5.660