EFFECTS OF FLUVOXAMINE AND MAPROTILINE ON ECG PARAMETERS

The cardiovascular effects of fluvoxamine and maprotiline were compare d in a double-blind trial; 33 patients (age 20-65 yrs) with ''major de pression'' (RDC) free from clinically relevant organic diseases were i nvestigated. After a 7-days washout a 3-weeks treatment phase was star ted with 200 mg daily of either fluvoxamine (n = 18) or maprotiline (n = 15). On clays 0, 7, 14 and 21 an ECG was performed and the drug pla sma levels were determined. Maprotiline caused an increase of the PR- (p <0.001), the ORS-interval (p <0.01) and of the heart rate ip <0.001 ). The QT(c)-interval was tendentially prolonged (p <0.10). P-wave dur ation and T-wave amplitude were not affected. No significant changes o f ECG parameters were observed with fluvoxamine; there was only a nons ignificant trend (p <0.10) for a lower heart-rate. Blood pressure was not affected by treatment with either antidepressant. In both groups n o significant correlations were found between ECG findings and the pla sma level. Conclusion: Prolongation of intracardiac conduction and a r ise in heart rate are cardiovascular effects of maprotiline which shou ld be taken into account when treating patients with concomitant cardi ac disease. Fluvoxamine in therapeutic dosage causes no alteration of the surface EGG.