PMID: 1361133Nov 1, 1992

Clinical course, therapy, outcome and analytical data in amitriptyline and combined amitriptyline/chlordiazepoxide overdose

Human & Experimental Toxicology
C KöppelJ Tenczer

Abstract

A total of 103 cases of amitriptyline (AT) overdose (group 1) and 81 cases of overdose with a fixed combination of AT and chlordiazepoxide (CDE) (group 2), treated at our Intensive Care Unit or reported to our Poison Information Center between 1985-1990, were evaluated with respect to clinical course, symptoms and outcome, as well as efficacy of therapy. The mean amount of AT was considerably higher in group 1 compared to group 2 (13 mg kg-1 vs 7.7 mg kg-1). The most frequent symptoms in both groups were impaired consciousness, anticholinergic symptoms, seizures, arrhythmia and hypotension. Respiratory insufficiency necessitated respirator therapy in 63 of the patients. Two patients in group 1 and one patient in group 2 did not survive. Therapy included primary detoxification by gastric lavage and repeated administration of activated charcoal. In four of eight patients with cardiac conduction disturbances, hypertonic sodium bicarbonate led to a significant reduction in QRS duration and AV interval. Physostigmine was effective in eight of 14 patients with pronounced anticholinergic symptoms. No effect was observed in the other six patients. Haemoperfusion, which was performed in five patients, led to rapid improvement of coma af...Continue Reading

References

Apr 1, 1978·Lancet·R S PedersenK N Christensen
Aug 1, 1979·Community Dentistry and Oral Epidemiology·C LindqvistL Teppo
Jun 8, 1979·JAMA : the Journal of the American Medical Association·L E Hollister
Mar 15, 1979·Toxicology and Applied Pharmacology·J P DesagerC Harvengt
Oct 1, 1979·British Journal of Clinical Pharmacology·R A BraithwaiteS Dawling
Dec 1, 1979·Critical Care Medicine·M E Kingston
Sep 1, 1979·Postgraduate Medical Journal·P Crome, B Newman
Jan 1, 1977·The American Journal of Psychiatry·J P O'Brien
Jan 1, 1990·Pharmacology & Therapeutics·M Eichelbaum, A S Gross
Jun 21, 1986·Lancet·J A Henry, S Cassidy
Mar 1, 1986·The American Journal of Emergency Medicine·M A LevittP R Finley
Jan 1, 1985·The Journal of Emergency Medicine·J R HedgesS A Syverud
Sep 1, 1986·Annals of Emergency Medicine·B I SasyniukM Valois
Jan 1, 1988·Journal of Toxicology. Clinical Toxicology·K KnudsenA Heath
Jan 1, 1988·Journal of Toxicology. Clinical Toxicology·K KnudsenA Heath
Oct 24, 1987·British Medical Journal·S Cassidy, J A Henry
Jan 1, 1985·Journal of Toxicology. Clinical Toxicology·H A Bessen, J T Niemann
Apr 1, 1986·Clinical Pharmacology and Therapeutics·B MellströmF Sjöqvist
Jun 17, 1972·Lancet·R A BraithwaiteA Coppen
Sep 16, 1972·Lancet·D C MoirR D Weir
Feb 16, 1974·British Medical Journal·K M Goel, R A Shanks
Dec 1, 1971·Clinica Chimica Acta; International Journal of Clinical Chemistry·R A Braithwaite, B Widdop
Jun 24, 1983·Deutsche medizinische Wochenschrift·J HildebrandtJ Schmidt
Jan 1, 1984·Contributions to Nephrology·J E SherlockJ M Letteri
Dec 1, 1984·Journal of Clinical Psychopharmacology·C M Swartz, A Sherman
Oct 1, 1983·Clinical Pharmacology and Therapeutics·B MellströmF Sjöqvist
Jan 1, 1982·European Journal of Clinical Pharmacology·B VandelR Volmat
May 1, 1982·Journal of Toxicology. Clinical Toxicology·A El-HageW L West
Mar 1, 1982·Journal of Toxicology. Clinical Toxicology·M V Rudorfer
Jan 1, 1982·Therapeutic Drug Monitoring·P A HalsJ Aarbakke
Jan 1, 1982·Archiv für Psychiatrie und Nervenkrankheiten·A E Balant-GorgiaG Garrone
Jul 1, 1981·The American Journal of Psychiatry·M V Rudorfer, E Robins
May 1, 1981·Clinical Toxicology·E G ComstockB S Comstock
Jul 1, 1983·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·P P KeohaneD B Silk

Citations

Apr 25, 2007·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·A D WoolfAmerican Association of Poison Control Centers
Oct 20, 2015·Resuscitation·Anatolij TruhlářCardiac arrest in special circumstances section Collaborators
May 1, 1996·Heart & Lung : the Journal of Critical Care·E N HeymanM Takacs
Apr 26, 2006·Human & Experimental Toxicology·Hüseyin CaksenCahide Yilmaz
May 1, 2007·Current Opinion in Critical Care·Melissa L Givens, Ellen O'Connell
Jan 5, 2006·Toxicological Reviews·H K Ruben Thanacoody, Simon H L Thomas
Jan 24, 2002·Therapeutic Drug Monitoring·Alison L Jones
Jan 14, 2021·ACS Chemical Neuroscience·Elliot W McClure, R Nathan Daniels

Related Concepts

Amitriptyline Hydrochloride
Librium
Dose-Response Relationship, Drug
Drug Interactions
Intensive Care Unit
Chromatography, Gas-Liquid-Mass Spectrometry
Transcription, Medical
Drug Overdose

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