Cardiac Complications in Amitriptyline Poisoning
Successful Treatment With Physostigmine
- Jonathan Tobis, MD;
- Bodh N. Das, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
THE USE of tricyclic antidepressant medications is increasing as a form of self-poisoning. There have been a number of reports of the anticholinergic effects of amitriptyline hydrochloride and imipramine hydrochloride.1 Although many cases of cardiotoxicity have been reported,2 there is little information concerning the treatment of the serious cardiac complications. Physostigmine salicylate has been used successfully to treat the central effects of tricyclic antidepressants, such as agitation, seizures, and coma, as well as their peripheral effects, such as tachycardia.1 We have used this drug in treating a young woman who had a cardiac arrest subsequent to an amitriptyline overdose. To our knowledge, this is the first reported case of amitriptyline poisoning in which malignant arrhythmias and conduction defects were successfully treated with physostigmine.
Report of a Case A 22-year-old woman ingested an estimated 750 to 1,000 mg of amitriptyline hydrochloride (Elavil) on March 25, 1975. She was
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