Tricyclic antidepressant overdose: clinical presentation and plasma levels.

Clinical Pharmacology and Therapeutics
D G SpikerJ T Biggs

Abstract

Fifteen patients were studied at 8- to 12-hr intervals during the first 24 hr after overdosing with tricyclic antidepressants, and subsequently followed daily for up to 144 hr. The severity of the overdose was determined by measuring the plasma tricyclic antidepressant level using gas chromatography-mass fragmentography. No correlation was found between total, tertiary, or desmethyl tricyclic antidepressant plasma levels and maximum heart rate, lowest blood pressure, degree of unconsciousness, or EKG changes involving the P-R interval or ST-T wave changes. There was a weak correlation between drug plasma level and maximum pupil size (r = 0.46; p less than 0.05) and a strong correlation between the duration of the QRS complex and tricyclic antidepressant plasma levels (r = 0.75; p less than 0.01). All patients with a total tricyclic antidepressant plasma level greater than or equal to 1,000 ng/ml had a QRS interval greater than or equal to 100 msec. As the total plasma tricyclic level fell, the duration of the QRS interval returned to normal. Thus, the duration of the QRS complex on the electrocardiogram appears to be the most reliable clinical sign for evaluating the seriousness of tricyclic antidepressant overdosage.

Citations

Jan 1, 1979·Clinical Toxicology·R Woodhead
Jan 27, 1977·The New England Journal of Medicine·J T BiggerA H Glassman
Jan 1, 1978·Acta Anaesthesiologica Scandinavica·S M Aquilonius, U Hedstrand
May 1, 1977·British Journal of Pharmacology·A BonaccorsiE Pita
Jul 1, 1977·Clinical and Experimental Pharmacology & Physiology·P DumovicG D Burrows
Jan 1, 1992·Journal of Toxicology. Clinical Toxicology·B A HulténA Heath
Dec 1, 1984·Acta Anaesthesiologica Scandinavica·J StrømM Bredgaard Sørensen
Jan 1, 1981·Acta Psychiatrica Scandinavica. Supplementum·C D Burgess
May 1, 1981·Clinical Toxicology·P Pentel, L Sioris
Jan 1, 1982·Annals of the New York Academy of Sciences·J T Bigger, F M Weld
May 1, 1981·Clinical Toxicology·M B NicotraM W Noall
Apr 1, 1995·Journal of Clinical Pharmacology·L P James, G L Kearns
Nov 10, 2004·Journal of Toxicology. Clinical Toxicology·Benoit BaileyDevendra K Amre
Sep 9, 2009·Human & Experimental Toxicology·Florian EyerThomas Zilker
Jan 1, 1992·Journal of Toxicology. Clinical Toxicology·B A HulténE Mårtensson
Jan 1, 1985·Journal of Toxicology. Clinical Toxicology·H A Bessen, J T Niemann
May 1, 1977·British Journal of Pharmacology·G BianchettiP L Morselli
Jan 1, 1985·Journal of Toxicology. Clinical Toxicology·F J BaudP E Fournier
Jan 1, 1989·Psychological Medicine. Monograph Supplement·S J WarringtonM Lader
Jan 1, 1980·Folia Psychiatrica Et Neurologica Japonica·S WatanabeC Kuyama
Jul 15, 2015·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Rebecca E Bruccoleri, Michele M Burns
Jul 1, 1988·Journal of Geriatric Psychiatry and Neurology·E V Beresin
Jan 1, 1987·Medical Toxicology·K R OlsonM T Kelley
Aug 1, 1982·Acta Pharmacologica Et Toxicologica·R VirtanenK Irjala
Jan 1, 1981·Journal of Toxicology and Environmental Health·D B Mitchell, D Acosta
Jan 1, 1982·European Journal of Clinical Pharmacology·O L PedersenM Brinklø
Mar 1, 1980·Acta Pharmacologica Et Toxicologica·J Müller, S Schulze
Jan 5, 2006·Toxicological Reviews·H K Ruben Thanacoody, Simon H L Thomas
Aug 23, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Ka Yuen Tang
Jan 1, 1997·Journal of Toxicology. Clinical Toxicology·A PoklisC R Crooks
Jan 1, 1984·Journal of Toxicology and Environmental Health·D Acosta, K Ramos
Jan 1, 1993·Journal of Toxicology. Clinical Toxicology·F S Messiha
Feb 24, 1977·The New England Journal of Medicine·W E Thornton
Sep 1, 1980·Clinical Toxicology·V L Zaratzian
Jan 1, 1990·Journal of Toxicology. Clinical Toxicology·A PoklisJ J Saady
Feb 1, 1982·Acta Pharmacologica Et Toxicologica·E J Erlandsen, L F Gram

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