The effects of diltiazem and metoprolol in QTc prolongation due to amitriptyline intoxication.
OBJECTIVE
Amitriptyline, a frequently used tricyclic antidepressant agent, has powerful cardiotoxic effects especially in high doses. Serum and urine levels of amitriptyline dosages are not correlated with severity of toxicity; therefore, it increases the importance of electrocardiography (ECG) abnormalities. The prolongation of QTc can be a predictive marker for cardiotoxicity. Hence, in this study, it is aimed to evaluate possible effects of metoprolol and diltiazem in amitriptyline toxicity.


METHODS
The rats were separated into four groups. First one was control group, the second was the amitriptyline + saline group, third one was the amitriptyline + metoprolol group, and forth one was the amitriptyline + diltiazem group. ECG were recorded on rats under anesthesia.


RESULTS
In amitriptyline group, QTc duration was prolonged compared with all other groups. The prolongation of QTc was shorter in amitriptyline + metoprolol group and amitriptyline + diltiazem group than amitriptyline group (p < 0.01 and p < 0.01, respectively).


CONCLUSIONS
According to the results, it is possible to report ameliorating effects of both metoprolol and diltiazem on QTc prolongation related with amitriptyline intoxication. With further studies, these agents may be used for amitriptyline toxicity and besides, they may be used for patients in cardiovascular risk groups who take amitriptyline treatment regularly.
Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey nursahbsl@gmail.com.
Nursah
N
Basol
Department of Physiology, Faculty of Medicine, Bilim University, Istanbul, Turkey.
Oytun
O
Erbas
D000639:Amitriptyline / Q000009:adverse effects*; D000818:Animals; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000188:drug therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004110:Diltiazem / Q000627:therapeutic use*; D008790:Metoprolol / Q000627:therapeutic use*; D051381:Rats
D000929:Antidepressive Agents, Tricyclic; D002317:Cardiovascular Agents; D000639:Amitriptyline; D004110:Diltiazem; D008790:Metoprolol
Amitriptyline; ECG; QTc; diltiazem; intoxication; metoprolol; poisoning