Summary
Systolic pressor effects after i.v. injection of tyramine (TA) were recorded in 13 patients before and during treatment with nortriptyline (NT) in doses of 1.4–5 mg/kg/day for 3–4 weeks. After NT a several fold decrease in the responsiveness to TA occurred. Patients given the same dose of NT showed markedly different decreases in the responsiveness to TA. There was no correlation between the blockade of the TA pressor effects and the dose of NT employed but there was an excellent correlation between the blockade and the plasma level of NT (p<0.001 and p<0.005 respectively). TA pressor effects were not changed in a small control group of depressed patients after treatment with E.C.T. The relationship between kinetics and effects of tricyclic antidepressants is discussed. The steady-state plasma level of NT seems to be an important determinant of its effects.
Similar content being viewed by others
References
Burn, J. H., Rand, M. J.: Action of sympathomimetic amines in animals treated with reserpine. J. Physiol. (London). 144, 314–336 (1958).
Borgå, O., Azarnoff, D. L., Plym Forshell, G., Sjögvist, F.: Plasma protein binding of tricyclic antidepressants in man. Biochem. Pharmacol. 18, 2135–2143 (1969).
— Hamberger, B., Malmfors, T., Sjögvist, F.: The role of plasma protein binding for the effect of nortriptyline on the neuronal uptake of noradrenaline. To be submitted to Clin. Pharmacol. Therap. (1970).
Brodie, B. B., Costa, E., Groppetti, A., Matsumoto, C. Interaction between desipramine, tyramine, and amphetamine at adrenergic neurones. Brit. J. Pharmacol. 34, 648–658 (1968).
—, Cosmides, G. J., Rall, D. P.: Toxicology and the biomedical sciences. Science 148, 1547–1554 (1965).
Carlsson, A.: Drugs which block the storage of 5-hydroxytryptamine and related amines. In: Handbuch der Exp. Pharmacol. Berlin-Göttingen-Heidelberg: Springer. Ed. V. Erspamer. 19, 529–592 (1965).
—: Recent studies on the mode of action of anti-depressive drugs. Naunyn-Schmiedebergs Arch. Pharmak. exp. path. 257, 115–117 (1967).
—: β-Hydroxylation of tyramine in vivo. Acta Pharmacol. 20, 371–374 (1963).
Engelman, K., Sjoerdsma, A.: A new test for pheochromacytoma. JAMA 2, 81–86 (1964).
Fischer, J. E., Musacchio, J., Kopin, J. J., Axelrod, J. Effects of denervation on the uptake and β-hydroxylation of tyramine in the rat salivary gland. Life Sci. 3, 413–419 (1964).
Gessa, G. L., Vargin, L., Crabai, F.: Interaction of desmethyl-imipramine (DMI) with the adrenergic and NE releasing actions of tyramine, α-methyl-m-tyramine, and metaraminol. Life Sci. 5, 501–507 (1966).
Hammar, C.-G., Sjögvist, F.: Gas chromatography —mass spectrometry of tricyclic antidepressants and certain metabolites in body fluids in man. To be submitted to Biochem. Pharmacol. (1969).
Hammer, W., Brodie, B.B.: Application of isotope derivative technique to assay of secondary amines: Estimation of desipramine by acetylation with H3-acetic anhydride. J. Pharmacol. exp. Ther. 157, 503–508 (1967).
—, Sjögvist, F.: Plasma levels of monomethylated tricyclic antidepressants during treatment with imipramine-like compounds. Life Sci. 6, 1895–1903 (1967).
Harakal, C., Sevy, R. W., Rusy, B. F.: Hemodynamic effects of tyramine. J. Pharmacol. exp. Ther. 144, 89–96 (1964).
—, —, Reidenberg, M.M., Faust, R.E.: Effect of adrenal medullectomy and total adrenalectomy on the hemodynamic responses to tyramine. J. Pharmacol. exp. Ther. 160, 292–299 (1968).
Klerman, G. L., Cole, J. O.: Clinical pharmacology of imipramine and related antidepressant compounds. Pharmacol. Rev. 17, 101–141 (1965).
Kopin, I. J., Fischer, J. E., Musacchio, J. M., Horst, W. D., Weise, V. K.: False neurochemical transmitters and the mechanism of sympathetic blockade by monoamine oxidase inhibitors. J. Pharmacol. exp. Ther. 147, 186–193 (1965).
Lemberger, L., Klutch, A., Kuntzman, R.: The metabolism of tyramine in rabbits. J. Pharmacol. exp. Ther. 153, 183–190 (1966).
Lindmar, R., Muscholl, E.: Die Verstärkung der Noradrenalinwirkung durch Tyramin. Naunyn-Schmiedebergs Arch. exp. Path. Pharmak. 252, 122–133 (1965).
Lockett, M. F., Eakins, K. E.: Chromatographic studies of the effect of intravenous injections of tyramine on the concentration of adrenaline and noradrenaline in plasma. J. Pharm. Pharmac. 12, 513–517 (1960).
Mitchell, J. R., Arias, L., Oates, J. A.: Antagonism of the antihypertensive action of guanethidine sulfate by desipramine hydrochloride. JAMA, 202, 973–976 (1967).
Pettinger, W., Horwitz, D., Spector, S., Sjoerdsma, A.: Enhancement by methyldopa of tyramine sensitivity in man. Nature 200, 1107–1108 (1963).
Pöch, G.R., Kopin, I.J.: The role of octopamine in tachyphylaxis to tyramine. Biochem. Pharmacol. 15, 210–212 (1966).
Siwers, B., Tuck, D., Freyschuss, U., Azarnoff, D. L., Sjögvist, F.: A novel approach to the phase-I clinical trial of tricyclic antidepressant drugs. Abstr. for Fourth Internat. Congr. on Pharmacol., July 14–18, 1969 Basel (1969).
Sjögvist, F.: Toxic interactions between monoamine oxidase inhibitors (MAOI) and other drugs. In: “Symposium on relationship between pharmacological actions of MAO-inhibitors and their effects in man”. Proc. III Internat. Pharmacol. Congr. Sao Paolo, July 1966, 10, 61–74 (1967).
— Hammer, W., Ideström, C.-M., Lind, M., Tuck, D., Åsberg, M.: Plasma level of monomethylated tricyclic antidepressants and side-effects in man. Proc. Eur. Soc. Study Drug Toxicity, Paris 1967, Excerpta Mod. Internat. Congr. Ser. No. 145, 246–257 (1968).
— — Borgå, O., Azarnoff, D. L. : Pharmacological significance of the plasma level of monomethylated tricyclic antidepressants. Proc. Coll. Internat. Neuropsychopharmacor., Tarragona, Spain, Excerpta Med. Internat. Congr. Ser. No. 180, 128–136 (1969).
Stjärne, L.: Tyramine effects on cateeholamine release from spleen and adrenals in the cat. Acta physiol. scand. 51, 224–229 (1961).
Studnitz von, W., Ljungberg, O.: Tyramine test and phaeochromocytoma. Acta med. scand. 182, 341–344 (1967).
Åsberg, M., Cronholm, B., Sjögvist, F., Tuck, D.: Subjective side-effects of nortriptyline: Correlation to the steady-state plasma level. Manuskript.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Freyschuss, U., Sjöqvist, F. & Tuck, D. Tyramine pressor effects in man before and during treatment with nortriptyline or ECT: Correlation between plasma level and effect of nortriptyline. Pharmacol. Clin. 2, 72–78 (1970). https://doi.org/10.1007/BF00420709
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00420709