Cholinergic dysfunction of heart, pupil, salivary glands, and urinary bladder in healthy volunteers during long-term treatment with clomipramine.

Cholinergic functions were studied in ten non-depressed healthy volunteers who were treated with 50 mg clomipramine daily for 3 weeks and subsequently with 100 mg daily for a further 3 weeks. Impairments in heart rate variation (HRV) at rest and standing, of the pupillary light response and of salivation were related to serum levels of clomipramine. Since reduction of HRV is closely related to dose (r = -0.83, P less than 10(-2] and is a better predictor of serum levels than the other measures examined, it is suggested that the easy obtainable function test of HRV at standing can be used as an estimate of over-all cholinergic dysfunction during treatment with tricyclic antidepressants.