Bestimmung von Amitriptylin und Metaboliten in verschiedenen Organen nach einer t�dlichen Vergiftung

Review of the career of Professor Dr. Herbert Remmer

This article is a laudatio summarizing the scientific career and accomplishments of Herbert Remmer as observed by one of his first students. The article traces over fifty years of multiple contributions of Herbert Remmer to pharmacology and toxicology and clearly identifies the leadership characteristics of this memorable man.

[Tricyclic antidepressants (TAD) as a cause of unexpected death (author's transl)]

This study points to the controversy over the anti-depressant efficacy of tricyclic antidepressant drugs (TAD) and emphasize their cardiotoxicity. The number of lethal poisoning cases--from the Swiss federal statistics on the cause of death--amounted to 54 for the period from 1967 to 1976. Ten of these 54 cases occurred in children who had ingested the drug accidentally; the remaining cases concerned adults who took an overdose of the drug intentionally. In addition, the authors reviewed the forensic medical examinations performed on 11 cases of unexpected death due to lethal poisoning with TAD. Our data indicated that fatality can follow drug intake quite rapidly. Autoptical and histological findings were not specific. To confirm a poisoning diagnosis, levels of TAD and their metabolites were therefore determined in nine cases in various organ tissues and body fluids. Poisoning was due to imipramine (3 cases), opipramol (2 cases), dibenzepine (3 cases), and amitriptyline (3 cases).

Effects of several tricyclic antidepressants on the hemodynamics and myocardial contractility of the anesthetized dogs

Cardiovascular effects of several imipramine analogs were investigated in the anesthetized mongrel dogs. Significant reduction in the cardiac output produced by lower doses (2.5 mg/kg, i.v.) of imipramine and 2-OH-DMI was not due to a depression of myocardial contractility. In contrast, 2-OH-imipramine (1.25 mg/kg) and DMI (2.5 mg/kg) significantly reduced contractility within 10 min after i.v. administration; however, significant decrease in the cardiac output did not occur until after 60 min. Higher doses (5 mg/kg) of imipramine, DMI and 2-OH-DMI significantly attenuated cardiac rate, contractility and output within 5 min after i.v. administration. 2-OH-imipramine, 2.5 mg/kg, i.v., depressed contractility and cardiac output to a degree equivalent to that produced by 5 mg/kg of imipramine, DMI and 2-OH-DMI. 3-Chloro-imipramine (5 mg/kg, i.v.) induced decrease in the cardiac output was essentially due to a significant reduction in the heart rate since the effects of this compound on the contractility were transient in nature. 3-Cl-8-OH-metabolite of this compound had no significant effects on the cardiovascular system. The results of this investigation demonstrated that the complex cardiovascular effects of tricyclic antidepressants observed in these studies were perhaps due to a direct and/or autonomically mediated effects on the heart and vasculature. Further, the data support the conclusions that the activity of the parent compounds together with that of the metabolites contributes to overall changes observed. While all the agents are capable of reducing cardiac output, 2-OH-metabolite of imipramine appears to be most toxic on the myocardium and 3-Cl-imipramine possessed only transient effects on the contractile properties.