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James L. Stinnett, MD; John Valentine, MD; Elias Abrutyn, MD

JAMA. 1968;204(1):69-71.

Abstract
In an attempt at suicide, a 25-year-old woman took an overdose of nortriptyline hydrochloride. She became hypotensive, comatose, and her respiration rate was depressed. The electrocardiogram showed a lengthened P-R interval. The clinical state cycled between central nervous system depression and lightening of the level of consciousness. Treatment consisted of gastric lavage, supportive therapy, and osmotic diuresis. It is suggested that osmotic diuresis or dialysis may be ineffective. Use of pyridostigmine bromide may be considered for serious ECG changes.

Author Affiliations
From the departments of psychiatry (Dr. Stinnett) and medicine (Drs. Valentine and Abrutyn), Hospital of the University of Pennsylvania, Philadelphia.

Footnotes
Reprint requests to 3400 Spruce St, Philadelphia 19104 (Dr. Stinnett).

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