Amitriptyline and Cardiac Disease

Coull, D.C.; Dingwall‐Fordyce, I.; Crooks, J.; Scott, Alwyn; Weir, Roy D.

doi:10.1016/s0140-6736(70)90169-8

Cited by 102 publications

(12 citation statements)

References 1 publication

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“…It may be, however, that some risk arises because of an association between personality type and the development of myocardial infarction (Jenkins, Rosenman, and Zynanski, 1974), or because of an effect of the drugs used to treat the complaints. Tricyclic antidepressants, for instance, have been associated with sudden and unexpected death in patients suffering from cardiac disease (Coull et al, 1970).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for myocardial infarction in young women.

Mann¹,

Doll²,

Thorogood³

et al. 1976

Journal of Epidemiology & Community Health

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94-100. Risk factors for myocardial infarction in young women. Seventy-seven women discharged from hospital with a diagnosis of myocardial infarction and 207 control patients were investigated. All were under 45 years of age at the time of admission. Heavy cigarette smoking, reported treatment for pre-eclamptic toxaemia, and type II hyperlipoproteinaemia were found to be independent risk factors for myocardial infarction. Reported treatment for hypertension and diabetes are probably also independently associated with subsequent development of the condition, but the associations between myocardial infarction and reported treatment for obesity and psychiatric illness appear to be secondary. Previous publications have suggested that use of oral contraceptives is an independent risk factor. Examination of the effect of several factors combined, suggests that they act synergistically, the presence of three or more factors increasing the risk 128-fold.We have recently reported observations which led to the conclusion that women who used oral contraceptives had an increased risk of myocardial infarction (Mann et al., 1975a, b). The observations were made as part of a study-of the causes of myocardial infarction in young women, but they could not all be examined in detail because of shortage of space. We report here, therefore, the results relating to risk factors other than the use of oral contraceptives, and the extent to which they operate independently.

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Section: Discussionmentioning

confidence: 99%

Risk factors for myocardial infarction in young women.

Mann¹,

Doll²,

Thorogood³

et al. 1976

Journal of Epidemiology & Community Health

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“…Recent work such as that of Alexander and Niino (1969) and Coull, Crooks, Dingwall-Fordyce, Scott, and Weir (1970) on the cardiovascular complications of long-term therapy with psychotropic drugs must be borne in mind.…”

Section: Discussionmentioning

confidence: 99%

Amitriptyline in migraine prophylaxis: Changes in pattern of attacks during a controlled clinical trial

Gomersall

Stuart

1973

Journal of Neurology, Neurosurgery & Psychiatry

173

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SUMMARY A double-blind controlled clinical trial of crossover design was conducted in 26 volunteers suffering from migraine. Of 20 subjects who completed the trial, 16 had fewer attacks on amitriptyline than on placebo. Amitriptyline was found to have the greatest effect in reducing attacks with a short warning and in which no specific cause could be recognized. It had least effect in attacks with a long warning and recognized as due to fatigue. The drug was effective only in reducing those attacks with shorter duration and its effect was irrespective of severity. A dosage of between 10 and 60 mg, usually taken at night, was found to be adequate.Amitriptyline has been found effective in chronic tension headache (Lance and Curran, 1964) and its beneficial use in migraine has been reported (Friedman, 1968;Mahloudji, 1969).Although its precise mode of action in migraine is uncertain, amitriptyline and the tricyclic antidepressants possess similarities in structure and pharmacological effect to some of the recently introduced prophylactic agents used in this condition. SELECTION OF SUBJECTSVolunteers were requested via the British Migraine Association and the press. The criteria of migraine used was the presence of intermittent headache with at least three of the following features: unilateral distribution, sensory prodromata, associated nausea; photophobia and throbbing.All subjects were asked to keep a record of their migraine attacks. These showed the information listed in Table 1. The charts were returned and discussed every two months with a statement as to their accuracy. It was indicated that attacks causing no disturbance of daily routine should be recorded as mild; those causing some lack of efficiency as moderate, and those causing complete disruption of usual activities should be recorded as severe.Of 114 volunteers, 94 were excluded as follows. Seventy-five were excluded before or during a 26 week control period. Only those subjects having more than two attacks per month and with over 50% described as at least of moderate severity were

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“…There were, however, changes in rhythm in all four subjects (see Results). Unexpected deaths have been reported in patients with heart disease who were taking amitriptyline (Coull et al, 1970) though not in those taking imipramine. A further study (Moir et al, 1972) has confirmed the amitriptyline findings and also revealed unexpected deaths in patients taking imipramine.…”

Section: Discussionmentioning

confidence: 99%

Interactions between Sympathomimetic Amines and Antidepressant Agents in Man

Boakes¹,

Laurence²,

Teoh³

et al. 1973

BMJ

133

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SummaryIntravenous infusions of phenylephrine, noradrenaiine, adrenaline, and isoprenaline were given to healthy human volunteers after five to seven days on phenelzine, tranylcypromine, or imipramine, and cardiovascular responses were compared with those observed under control conditions. With monoamine oxidase inhibitors there was a 2-2k fold potentiation of the pressor effect of phenylephrine, but no clinically significant potentiation of cardiovascular effects of noradrenaline, adrenaline, or isoprenaline. With imipramine there was potentiation of the pressor effects ofphenylephrine (2-3 fold), noradrenaline (4-8 fold), and adrenaline (2-4 fold); there were dysrhythmias during adrenaline infusions, but no noticeable or consistent changes in response to isoprenaline.Noradrenaline and adrenaline in amounts contained in local anaesthetics used in dentistry are not likely to be significantly potentiated in otherwise healthy patients receiving monoamine oxidase inhibitors. Hazardous potentiation of their cardiovascular effects might occur in patients receiving tricyclic antidepressants.Our observations do not indicate that the hazards associated with isoprenaline inhalation by bronchial

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Amitriptyline and Cardiac Disease

Cited by 102 publications

References 1 publication

Risk factors for myocardial infarction in young women.

Risk factors for myocardial infarction in young women.

Amitriptyline in migraine prophylaxis: Changes in pattern of attacks during a controlled clinical trial

Interactions between Sympathomimetic Amines and Antidepressant Agents in Man

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