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The authors treated 44 outpatients 55 years old or older who were suffering from major depression with either nortriptyline, phenelzine, or placebo for 7 weeks. Plasma levels of nortriptyline were kept between 50 and 170 ng/ml, and platelet monoamine oxidase (MAO) inhibition in phenelzine-treated patients was kept between 70% and 80%. ECGs were compared before and after treatment. Nortriptyline produced statistically significant increases in both the heart rate and the PR interval, although none was outside the normal range. Phenelzine produced a significant decrease in the QT interval. None of the patients had pathological ECG changes under the closely monitored treatment conditions of this study.
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