Tricyclic antidepressant overdose: incidence of symptoms
J. T. Biggs, D. G. Spiker, J. M. Petit and V. E. Ziegler
Forty consecutively hospitalized patients who had overdosed primarily with
a tricyclic antidepressant (TCA) were observed until discharge. The
severity of the overdose was documented by serial measurements of plasma
TCA levels. Nineteen of the patients became comatose, 16 required
supportive respiration, and 2 died. Individual symptoms in the 13 patients
having plasma TCA levels greater than 1,000 ng/ml are shown. Plasma TCA
measurements more reliably define patients who are at risk for major
medical complications following overdose than does the amount of drug
ingested by history. In the absence of plasma measurements, a QRS duration
of 100 msec or more on a routine ECG within the first 24 hours defined all
patients with major TCA overdoses.
