Protriptyline toxicity

Cardiovascular disorders Use with extreme caution in patients with cardiovascular disorders because of the possibility of conduction defects, arrhythmias, CHF, sinus tachycardia. Ml, strokes, and tachycardia. These patients require cardiac surveillance at all dose levels of the drug. In high doses, TCAs may produce arrhythmias, sinus tachycardia, conduction defects, and prolonged conduction time. Tachycardia and postural hypotension may occur more frequently with protriptyline. Hyperthyroid patients Hyperthyroid patients or those receiving thyroid medication require close supervision because of the possibility of cardiovascular toxicity, including arrhythmias. 

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