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Najib Babul, RPh
State University of New York at Buffalo

Susan Rozek, PharmD
Erie County Medical Center State University of New York at Buffalo

JAMA. 1987;257(18):2435.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The article entitled "Tricyclic Antidepressant Overdose: A Review"¹ provides a useful reference for the management of antidepressant overdose. However, several important issues relating to the newer antidepressants deserve mention.

In addition to the significant central nervous system toxicity observed with amoxapine overdosage,¹ renal failure may develop several days after acute ingestion in patients who otherwise appear to have recovered.² In a series of 112 cases of amoxapine overdosage reported by Jennings et al,² 13 cases of acute renal failure developed. Evidence of acute tubular necrosis with rhabdomyolysis and myoglobinuria was a frequent finding in these patients and approximately 40% of these patients required dialysis.²

With regard to trazodone hydrochloride, the authors note that "trazodone appears to be much less toxic than TCAs [tricyclic antidepressants] after acute overdose." Although an earlier report of 206 cases of trazodone overdosage³ found no fatalities, a . . . [Full Text PDF of this Article]

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