Incidence of orthostatic hypotension in patients with primary affective disorders treated with tricyclic antidepressants.

Previous studies have indicated that postural hypotension is an uncommon event when tricyclic antidepressants are used in the treatment of depression, and other studies have indicated that postural hypotension is a possible predictor of positive therapeutic response to antidepressant therapy. In this study, 20 depressed patients with the diagnosis of primary affective disorders were hospitalized and treated with tricyclic antidepressants. All patients had been without medication for at least 2 weeks before the study began. Blood pressure recordings were made after a 5-minute resting period and then followed by another reading after the patient had been standing for 2 minutes. Our findings indicate that these patients with primary affective disorders developed significant orthostatic hypotension. It is our belief that orthostatic hypotension is a significant event in patients who have primary affective disorders treated with tricyclic antidepressants, and this sign should be looked for in all patients regardless of age or the presence of significant cardiovascular disease.