title: Amitriptyline-induced ophthalmoplegia.
abstract: Total external ophthalmoplegia, unresponsive to caloric stimulation, was observed in a gravid woman who had ingested approximately 1.0 to 1.5 gm of amitriptyline. The intravenous administration of 4.0 mg physostigmine salicylate (PS) produced a revival of consciousness and reflex activity but had no appreciable effect on ocular motility. A prior case report of amitriptyline-induced ophthalmoplegia in a patient who took lesser amounts of the medication described immediate restoration of eye movement with only 2 mg of intravenous PS. The action of the amitriptyline on the vestibuloocular reflex seems to involve cholinergic transmission and the effect of the drug may be dose related.
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced / Q000188:drug therapy; D005260:Female; D006801:Humans; D009886:Ophthalmoplegia / Q000139:chemically induced*; D010830:Physostigmine / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*
chemical_list: D000639:Amitriptyline; D010830:Physostigmine