Evaluation of myocardial cell damage by In-111-monoclonal antimyosin antibodies in patients under chronic tricyclic antidepressant drug treatment.
BACKGROUND
The capability of chronic tricyclic antidepressant drug (TAD) treatment to elicit myocardial damage has been a subject of debate. Lack of an adequate noninvasive method to detect such damage has prevented an in-depth study.


RESULTS
A prospective study with In-111-monoclonal antimyosin antibodies was undertaken in a series of 21 young patients with major depression on TADs and a control group of 19 healthy subjects. A heart-to-lung ratio (HLR) of antimyosin uptake was used to discriminate normal from abnormal scans. HLR in healthy subjects was 1.39 +/- 0.08. Patients on imipramine (HLR, 1.41 +/- 0.09) or clomipramine (HLR, 1.44 +/- 0.06) showed normal studies. Those under amitriptyline had a higher HLR (1.58 +/- 0.12) compared with nonamitriptyline or normal groups (P < .05). None of the 15 patients on imipramine or clomipramine showed abnormal HLR, while 3 of 6 on amitriptyline did (P < .01). In these 3 patients, uptake decreased or disappeared after drug withdrawal. Ejection fraction was normal in every patient.


CONCLUSIONS
Monoclonal antimyosin antibody studies are normal in imipramine- and clomipramine-treated patients. Antibody uptake in those under amitriptyline treatment, which disappears after drug withdrawal, would suggest early evidence of myocardial toxicity.
Martí
V
V
Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Ballester
M
M
Udina
C
C
Carrió
I
I
Alvarez
E
E
Obrador
D
D
Pons-Lladó
G
G
D000328:Adult; D000911:Antibodies, Monoclonal; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000000981:diagnostic imaging; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D009218:Myosins / Q000276:immunology*; D011877:Radionuclide Imaging
D000911:Antibodies, Monoclonal; D000929:Antidepressive Agents, Tricyclic; D007205:Indium Radioisotopes; D009218:Myosins