Marplan, Nardil and Parnate), Tricyclic (ie: Anafranil, Elavil, Pamelor, Sinequan and Tofranil) and Tetracyclic (ie: Desyrel and Remeron) classes, as those possess potent anticholinergic and alpha-adrenergic properties, and hence, are cardio-toxic. SNRI's (Cymbalta, Effexor and Pristiq) are relative contraindications, as they have the potential to severely raise blood pressure and induce left ventricular hypertrophy.