Reversal of dilated cardiomyopathy after chronic tricyclic antidepressant drug withdrawal

Two patients referred for heart transplantation for dilated cardiomyopathy on chronic tricyclic antidepressant treatment are described. Echocardiographic normalization of left ventricular diameters and function were evidenced after drug withdrawal, suggesting drug-induced toxic myocardial disease. The possibility of functional improvement after tricyclic antidepressant drug withdrawal should be kept in mind before including patients with dilated cardiomyopathy in a heart transplantation program.