Review of clinical and animal studies comparing the cardiovascular effects of doxepin and other tricyclic antidepressants

On the basis of early reports suggesting that doxepin has fewer cardiovascular effects than do other tricyclic antidepressants, doxepin continues to be recommended for the treatment of depression in cardiac patients and in the elderly. However, these reports have been criticized, and other evidence has suggested opposite conclusions. To clarify this issue, the author reviewed clinical and animal studies and found that, in general, doxepin has an effect comparable to the effects of other tricyclic antidepressants on cardiac conduction, cardiac rhythm, heart rate, blood pressure, and cardiac mechanics.