[Tricyclic antidepressants in depressed patients with cardiovascular diseases: a contraindication?].

Depressive disorder and cardiovascular diseases occur quite frequently together in the same patient, especially in older patients. On the one hand depressions can increase the risk of cardiovascular diseases, on the other hand cardiac disease can lead to depressive disorders in need of treatment. Thus the problem of prescribing tricyclics for patients with cardiovascular diseases is of great clinical relevance. In our review we summarize first of all the important cardiovascular effects of tricyclics in healthy persons and patients with cardiovascular diseases. Indications and (relative) contraindications for this medication with respect to cardiovascular disorders and proposals for diagnostic procedures in the beginning and during the course of antidepressant medication are following. Finally we present some recommendations for the treatment of tricyclic-induced side effects.