title: The treatment of tricyclic antidepressant overdose with repeated charcoal.
abstract: Activated charcoal given repeatedly through a nasogastric tube to three patients in coma from amitriptyline overdose greatly accelerated tricyclic elimination: the apparent half-life fell below 10 hours for each patient to as low as 4 hours. This contrasts with extended half-lives for amitriptyline elimination averaging 36.8 hours and regularly over 60 hours previously reported for overdoses treated without repeated charcoal. The enterohepatic recirculation of amitriptyline and nortriptyline appears to be a major influence on keeping their blood levels up. In one case, intravenous diazepam inhibited tricyclic elimination.
mesh_terms: D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000097:blood / Q000506:poisoning; D000929:Antidepressive Agents, Tricyclic / Q000097:blood / Q000506:poisoning*; D002606:Charcoal / Q000627:therapeutic use*; D004764:Enterohepatic Circulation; D005260:Female; D006207:Half-Life; D006801:Humans; D007099:Imipramine / Q000097:blood / Q000506:poisoning; D007441:Intubation, Gastrointestinal; D007700:Kinetics
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002606:Charcoal; D000639:Amitriptyline; D007099:Imipramine