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Heart failure associated with high plasma 10-hydroxynortriptyline levels

Published Online:https://doi.org/10.1176/ajp.141.3.432

The authors describe a patient who developed congestive heart failure and had a high plasma concentration of 10-hydroxynortriptyline. They discuss the need for further research to define the contribution of antidepressants' active metabolites to toxic and therapeutic effects.

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