title: Tricyclic antidepressant overdose.
abstract: Overdose of a tricyclic antidepressant is a serious and all-too-frequent occurrence. The diagnosis must be considered in known or suspected overdoses, and signs such as a dry axilla, tachycardia, and wide QRS must be specifically sought. Management depends upon support of vital functions and a thorough understanding of the pharmacology of the drug. Emptying the gastrointestinal tract with ipecac or lavage and hastening elimination with activated charcoal and a cathartic are extremely important measures. Cardiac arrhythmias generally respond to sodium bicarbonate, and seizures respond to intravenous diazepam. Neither physostigmine nor dialysis are considered to be treatments of choice. As in other overdoses, counseling to prevent ingestions is more than worth "a pound of the cure."
mesh_terms: D000042:Absorption; D000138:Acidosis / Q000139:chemically induced; D000929:Antidepressive Agents, Tricyclic / Q000378:metabolism / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000188:drug therapy; D002319:Cardiovascular System / Q000187:drug effects; D002490:Central Nervous System / Q000187:drug effects; D002606:Charcoal / Q000378:metabolism / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D007022:Hypotension / Q000139:chemically induced / Q000628:therapy; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced / Q000188:drug therapy; D012137:Respiratory System / Q000187:drug effects; D012640:Seizures / Q000139:chemically induced / Q000188:drug therapy
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002606:Charcoal