Abstract
Tricyclic antidepressive agents are widely used in suicide attempts and present a variety of deleterious effects. Rhabdomyolysis is a rare complication of such poisoning. A 55-year-old woman ingested 120 pills of 25 mg clomipramine in a suicide attempt two days before admission. After gastric lavage in another emergency department on the day of intake, 80 pills were removed. On admission to our department, she was disoriented, complaining of a dry mouth and tremors at the extremities. An electrocardiogram showed a sinus rhythm with narrow QRS complexes. Laboratory results showed high creatine phosphokinase (CK = 15,094 U/l on admission; normal range = 26 to 140 U/l), hypocalcemia, slightly increased serum transaminases and mild metabolic acidosis. The patient's medical history included depression with previous suicide attempts, obsessive-compulsive disorder, hypothyroidism and osteoporosis. She presented cardiac arrest with pulseless electric activity for seven minutes and afterwards, without sedation, showed continuous side-to-side eye movement. She developed refractory hypotension, with need for vasopressors. Ceftriaxone and clindamycin administration was started because of a hypothesis of bronchoaspiration. The patient remai...Continue Reading
References
Sep 1, 1979·Journal of the Royal Society of Medicine·P Crome, B Newman
Oct 5, 1992·The Medical Journal of Australia·J ColeridgeJ J McNeil
Jan 1, 1989·Acta Psychiatrica Scandinavica. Supplementum·R D Farmer, R M Pinder
Jan 1, 1989·Acta Psychiatrica Scandinavica. Supplementum·J A Henry
Jun 1, 1985·Annals of Emergency Medicine·K KuligB H Rumack
May 1, 1986·Annals of Emergency Medicine·W O'RiordanR L Stennes
Nov 1, 1986·Annals of Emergency Medicine·S B McAlpineF M Burkle
Aug 22, 1985·The New England Journal of Medicine·M T Boehnert, F H Lovejoy
Sep 30, 1967·British Medical Journal·A B Masters
Jan 1, 1983·Acta Medica Scandinavica·B A Hultén, A Heath
Oct 24, 1980·JAMA : the Journal of the American Medical Association·J B Marshall
Jan 28, 1995·BMJ : British Medical Journal·S S JickH Jick
Mar 1, 1995·The Journal of Emergency Medicine·G M BosseG C Rodgers
Jan 28, 1995·BMJ : British Medical Journal·J A HenryE K Sener
Feb 20, 1995·The Medical Journal of Australia·N A BuckleyN W Ferguson
Jan 1, 1994·Journal of Toxicology. Clinical Toxicology·R J RobergeJ G Benitez
Jun 1, 1994·Human & Experimental Toxicology·J O Obafunwa, A Busuttil
Jan 1, 1997·Intensive Care Medicine·B FrançoisH Gastinne
Apr 16, 1998·Journal of Toxicology. Clinical Toxicology·A Ferrer-DufolJ M Marques-Alamo
Jun 3, 1998·Intensive Care Medicine·E StevensN Jaspar
Jul 4, 2001·Emergency Medicine Journal : EMJ·G W KerrS Wilkie
Jul 19, 2006·Journal of Occupational Medicine and Toxicology·Shiven B Chabria
Citations
Feb 28, 2019·Journal of Medical Case Reports·Stephan von DüringLaurent Christin
Jul 2, 2016·Proceedings·Chibuzo Clement OdigweNkemakolam Iroegbu
Oct 28, 2021·Journal of Psychopharmacology·Tian LanGuo-Xin Hu
Oct 29, 2021·Internal Medicine·Shohei ObayashiYoko Ito