Journal ArticleDOI
Tricyclic antidepressant plasma levels and adverse effects after overdose.
James M. Petit,Duane G. Spiker,Joseph F. Ruwitch,Vincent E. Ziegler,Alan N. Weiss,John T. Biggs +5 more
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TLDR
Measurement of total TAD (free and protein‐bound) appears to correlate well with biologic response as well as with major adverse effects and electrocardiographic findings.Abstract:
Forty patients ingesting tricyclic antidepressant (TAD) overdoses were studied as a pharmacologic model to determine whether total tricyclic antidepressant plasma levels correlated with major adverse effects and electrocardiographic findings. Maximum TAD plasma levels were higher in patients who died (p less than 0.025) or had cardiac arrest (p less than 0.02), needed respiratory support (p less than 0.005), were unconscious (p less than 0.02), had grand mal seizures (p less than 0.001), ventricular rate larger than or equal to 120/min (p less than 0.01), cardiac arrhythmia (p less than 0.05), QRS duration larger than or equal to 100 msec (p less than 0.001), or bundle branch block (p less than 0.05). TAD plasma levels correlated with the dose ingested by history (N = 29, r = 0.58, p less than 0.001). Measurement of total TAD (free and protein-bound) appears to correlate well with biologic response.read more
Citations
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Journal ArticleDOI
Value of the QRS Duration versus the Serum Drug Level in Predicting Seizures and Ventricular Arrhythmias after an Acute Overdose of Tricyclic Antidepressants
TL;DR: It is concluded that determination of the maximal limb-lead QRS duration predicts the risk of seizures and ventricular arrhythmias in acute overdose with tricyclic antidepressants.
Journal ArticleDOI
Tricyclic antidepressant overdose: a review.
TL;DR: This review discusses the pharmacokinetics, clinical presentation and treatment of tricyclic overdose, which is among the commonest causes of drug poisoning seen in accident and emergency departments.
Journal ArticleDOI
Cardiovascular Effects of Therapeutic Doses of Tricyclic Antidepressants: A Review
Glassman Ah,Bigger Jt +1 more
TL;DR: Overdose of tricyclic antidepressants (TCAs) leave no doubt that TCA drugs at high concentrations have serious cardiac effects, but recent prospective, plasma-level-controlled studies have improved understanding of these drugs and proved assumptions to be inaccurate.
Journal ArticleDOI
Tricyclic antidepressant poisoning : cardiovascular toxicity.
TL;DR: Although a QRS duration >100ms and a rightward T 40ms axis appear to be better predictors of cardiovascular toxicity than the plasma tricyclic drug concentration, they have at best moderate sensitivity and specificity for predicting complications.
Journal ArticleDOI
Tricyclic antidepressant overdose.
TL;DR: Current knowledge on TCA overdose and toxicity is reviewed, with particular emphasis on pharmacology as the foundation of rational therapy.
References
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Journal ArticleDOI
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Journal ArticleDOI
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Journal ArticleDOI
Tricyclic antidepressant overdose: Clinical presentation and plasma levels
TL;DR: 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.