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Toxicity, Antidepressant: Multimedia

Author: Jeena Jacob, MD, PharmD, Resident Physician, Department of Emergency Medicine, Yale-New Haven Hospital
Contributor Information and Disclosures

Updated: Nov 13, 2008

Multimedia

Toxicity, antidepressant. ECG shows the terminal ...Media file 1: Toxicity, antidepressant. ECG shows the terminal R wave in aVR and the widened QRS complex associated with tricyclic antidepressant (TCA) toxicity.
Toxicity, antidepressant. ECG shows the terminal ...

Toxicity, antidepressant. ECG shows the terminal R wave in aVR and the widened QRS complex associated with tricyclic antidepressant (TCA) toxicity.

More on Toxicity, Antidepressant

Overview: Toxicity, Antidepressant
Differential Diagnoses & Workup: Toxicity, Antidepressant
Treatment & Medication: Toxicity, Antidepressant
Follow-up: Toxicity, Antidepressant
Multimedia: Toxicity, Antidepressant
References

References

  1. Bronstein AC, Spyker DA, Cantilena LR Jr, et al. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). Dec 2007;45(8):815-917. [Medline][Full Text].

  2. Heard K, Dart RC, Bogdan G, et al. A preliminary study of tricyclic antidepressant (TCA) ovine FAB for TCA toxicity. Clin Toxicol (Phila). 2006;44(3):275-81. [Medline].

  3. Bailey B, Buckley NA, Amre DK. A meta-analysis of prognostic indicators to predict seizures, arrhythmias or death after tricyclic antidepressant overdose. J Toxicol Clin Toxicol. 2004;42(6):877-88. [Medline].

  4. Barry JD, Durkovich DW, Williams SR. Vasopressin treatment for cyclic antidepressant overdose. J Emerg Med. Jul 2006;31(1):65-8. [Medline].

  5. Bebarta VS, Phillips S, Eberhardt A, et al. Incidence of Brugada electrocardiographic pattern and outcomes of these patients after intentional tricyclic antidepressant ingestion. Am J Cardiol. Aug 15 2007;100(4):656-60. [Medline].

  6. Fletcher SE, Case CL, Sallee FR, et al. Prospective study of the electrocardiographic effects of imipramine in children. J Pediatr. Apr 1993;122(4):652-4. [Medline].

  7. Graudins A, Dowsett RP, Liddle C. The toxicity of antidepressant poisoning: is it changing? A comparative study of cyclic and newer serotonin-specific antidepressants. Emerg Med (Fremantle). Dec 2002;14(4):440-6. [Medline].

  8. Høegholm A, Clementsen P. Hypertonic sodium chloride in severe antidepressant overdosage. J Toxicol Clin Toxicol. 1991;29(2):297-8. [Medline].

  9. Liebelt EL, Francis PD, Woolf AD. ECG lead aVR versus QRS interval in predicting seizures and arrhythmias in acute tricyclic antidepressant toxicity. Ann Emerg Med. Aug 1995;26(2):195-201. [Medline].

  10. Liebelt EL, Ulrich A, Francis PD, et al. Serial electrocardiogram changes in acute tricyclic antidepressant overdoses. Crit Care Med. Oct 1997;25(10):1721-6. [Medline].

  11. McCabe JL, Cobaugh DJ, Menegazzi JJ, et al. Experimental tricyclic antidepressant toxicity: a randomized, controlled comparison of hypertonic saline solution, sodium bicarbonate, and hyperventilation. Ann Emerg Med. Sep 1998;32(3 Pt 1):329-33. [Medline].

  12. McKenzie MS, McFarland BH. Trends in antidepressant overdoses. Pharmacoepidemiol Drug Saf. May 2007;16(5):513-23. [Medline].

  13. McKinney PE, Rasmussen R. Reversal of severe tricyclic antidepressant-induced cardiotoxicity with intravenous hypertonic saline solution. Ann Emerg Med. Jul 2003;42(1):20-4. [Medline].

  14. Monteban-Kooistra WE, van den Berg MP, Tulleken JE, et al. Brugada electrocardiographic pattern elicited by cyclic antidepressants overdose. Intensive Care Med. Feb 2006;32(2):281-5. [Medline].

  15. Obrador D, Ballester M, Carrio I, et al. Presence, evolving changes, and prognostic implications of myocardial damage detected in idiopathic and alcoholic dilated cardiomyopathy by 111In monoclonal antimyosin antibodies. Circulation. May 1994;89(5):2054-61. [Medline].

  16. Svens K, Ryrfeldt A. A study of mechanisms underlying amitriptyline-induced acute lung function impairment. Toxicol Appl Pharmacol. Dec 15 2001;177(3):179-87. [Medline].

  17. Thanacoody HK, Thomas SH. Tricyclic antidepressant poisoning : cardiovascular toxicity. Toxicol Rev. 2005;24(3):205-14. [Medline].

  18. Tran TP, Panacek EA, Rhee KJ, et al. Response to dopamine vs norepinephrine in tricyclic antidepressant-induced hypotension. Acad Emerg Med. Sep 1997;4(9):864-8. [Medline].

  19. Woolf AD, Erdman AR, Nelson LS, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(3):203-33. [Medline].

  20. Zuidema X, Dünser MW, Wenzel V, et al. Terlipressin as an adjunct vasopressor in refractory hypotension after tricyclic antidepressant intoxication. Resuscitation. Feb 2007;72(2):319-23. [Medline].

Further Reading

Keywords

antidepressant toxicity, antidepressant overdose, tricyclic antidepressants, TCAs, cyclic antidepressants, antidepressant poisoning, TCA toxicity, TCA overdose, TCA exposure, treatment of depression

Contributor Information and Disclosures

Author

Jeena Jacob, MD, PharmD, Resident Physician, Department of Emergency Medicine, Yale-New Haven Hospital
Jeena Jacob, MD, PharmD is a member of the following medical societies: American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David C Lee, MD, Research Director, Department of Emergency Medicine, Associate Professor, North Shore University Hospital and New York University Medical School
David C Lee, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

Michael J Burns, MD, Instructor, Department of Emergency Medicine, Harvard University Medical School, Beth Israel Deaconess Medical Center
Michael J Burns, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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