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Intensive Care Med. 1995 Jul;21(7):598-601.

Decreased R-R variation: a criterium for overdosage of tricyclic psychotropic drugs.

Author information

1
Psychiatrische Universitätsklinik, Erlangen, Germany.

Abstract

OBJECTIVE:

Since intoxication with tricyclic antidepressants is common, a supplementary screening method for differentiation between therapeutic and supratherapeutic ranges would be a valuable diagnostic tool, particularly in delirious and unconscious patients.

SETTING:

108 patients treated with amitriptyline, 8 patients treated with doxepin, 10 patients treated with clozapine, and 72 normal control subjects matched for age and sex were tested for heart rate variability while resting.

RESULTS:

Considering time and frequency derived measures, which are rather independent of heart rate, the patients showed significantly decreased heart rate variability parameters (p < 0.0001), as compared with the normal subjects. Of the patients presenting delirious symptoms 6 showed coefficients of variation more than 4 standard deviations below the mean control value.

CONCLUSIONS:

As heart rate variability can be easily calculated, this measurement is suggested as a useful tool to quickly exclude or support the diagnosis of chronic intoxication with tricyclic antidepressants or clozapine.

PMID:
7593904
[Indexed for MEDLINE]

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