Tobis J M, Aronow W S
Clin Pharmacol Ther. 1981 Mar;29(3):359-64. doi: 10.1038/clpt.1981.49.
The cardiotoxicity of the tricyclic antidepressants amitriptyline and doxepin were compared in an animal with acute overdose. The mean repetitive extrasystole threshold (RET) decreased 71.5% with amitriptyline and 27.5% with doxepin (mean blood levels 933 ng/ml and 1889 ng/ml). Physostigmine reversed these effects. Sodium bicarbonate had a variable effect on the lowered RET. The toxic arrhythmogenic effects of the tricyclic antidepressants can be measured by RET and are partly autonomic tone manipulation. In the same blood level range, doxepin is less toxic than amitriptyline.
在急性过量用药的动物模型中比较了三环类抗抑郁药阿米替林和多塞平的心脏毒性。阿米替林使平均重复性期前收缩阈值(RET)降低71.5%,多塞平使其降低27.5%(平均血药浓度分别为933 ng/ml和1889 ng/ml)。毒扁豆碱可逆转这些效应。碳酸氢钠对降低的RET有不同影响。三环类抗抑郁药的毒性致心律失常作用可通过RET来衡量,且部分是自主神经张力的调节。在相同血药浓度范围内,多塞平的毒性低于阿米替林。