Electrocardiogram Changes and Therapeutic Desipramine and 2-Hydroxy-Desipramine Concentrations in Elderly Depressives
Stan Kutcher, Kieran F. Reid, James Dubbin, Kenneth I. Shulman
Abstract
Stan Kutcher, Kieran F. Reid, James Dubbin, Kenneth I. Shulman
Abstract
ECG parameters in elderly depressed in-patients were assessed during routine desipramine treatment. Significant changes (prolonged PR and PRS intervals and a decreased QTc interval) were found, related only to steady state concentrations of desipramine's major metabolite--2-hydroxy-desipramine. Potentially clinically significant changes developed in 40% of the patients. All serum drug concentrations were within therapeutic limits. Previous assurances about desipramines's cardiac safety in the elderly may need to be re-evaluated.
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ECG parameters in elderly depressed in-patients were assessed during routine desipramine treatment. Significant changes (prolonged PR and PRS intervals and a decreased QTc interval) were found, related only to steady state concentrations of desipramine's major metabolite--2-hydroxy-desipramine. Potentially clinically significant changes developed in 40% of the patients. All serum drug concentrations were within therapeutic limits. Previous assurances about desipramines's cardiac safety in the elderly may need to be re-evaluated.
Key concepts: Desipramine, Metabolite, Medicine, Internal medicine, Plasma concentration, Pharmacology, Cardiology, Anesthesia