Identifying delirious states and autonomic cardiovascular dysfunction associated with amitriptyline treatment by standardized analysis of heart rate.
Ninety-one patients treated with amitriptyline and 60 normal control subjects underwent a standardized heart rate analysis in supine posture. Tests included the determination of time- and frequency-derived measurements of heart rate variability. The patients differed significantly from the control subjects in all parameters investigated. Two-thirds of the patients treated with a tricyclic antidepressant (TCA) reached values that met the criteria for cardiovascular autonomic neuropathy. Our results provide evidence that heart rate analysis might be a more sensitive tool in diagnosing amitriptyline-associated anticholinergic delirium than determination of TCA plasma levels. Further research is needed to elucidate what implications the TCA-associated alteration of autonomic cardiovascular function might have for patients.
Rechlin
T
T
Department of Psychiatry, University of Erlangen-Nuremberg, Psychiatrische Universitätsklinik, Germany.
Weis
M
M
Claus
D
D
Kaschka
W P
WP
D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001342:Autonomic Nervous System Diseases / Q000188:drug therapy / Q000503:physiopathology*; D002319:Cardiovascular System / Q000294:innervation*; D003693:Delirium / Q000139:chemically induced*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline