title: Phenytoin: the drug of choice in tricyclic antidepressant overdose?
abstract: Tricyclic antidepressants seem to have at least three types of effect on the heart: anticholinergic, adrenergic, and quinidine-like. Although the therapeutic emphasis in tricyclic antidepressant overdose has been on reversing the anticholinergic effects with physostigmine, there is considerable evidence suggesting that the life-threatening manifestations of tricyclic antidepressant overdose--the conduction defects, bradyarrhythmias, heart block, etc--are much more like quinidine and are more appropriately treated with phenytoin, or other drugs which enhance intracardiac conduction and myocardial contractility.
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D006331:Heart Diseases / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D010672:Phenytoin / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000889:Anti-Arrhythmia Agents; D000929:Antidepressive Agents, Tricyclic; D010672:Phenytoin