Hyperthermia complicating tricyclic antidepressant overdose.
We observed a 51-year-old woman who was admitted for severe amitriptyline overdose. Besides major cardiovascular complications, the patient developed severe hyperpyrexia with a central body temperature of more than 43 degrees C for 5 h. The patient died on day 3 from cardiocirculatory collapse and arrhythmias. Hyperthermia was unresponsive to cooling with ice water, gastric lavage, muscle relaxation, and dantrolene and bromocriptine administration. The possible mechanisms of refractory hyperthermia are discussed.
Hantson
P
P
Réanimation Toxicologique, Hôpital Fernand Widal, Paris, France.
Benaissa
M
M
Clemessy
J L
JL
Baud
F J
FJ
D000639:Amitriptyline / Q000506:poisoning*; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D001831:Body Temperature; D001971:Bromocriptine / Q000627:therapeutic use; D017679:Cryotherapy; D003620:Dantrolene / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D012769:Shock / Q000175:diagnosis
D000929:Antidepressive Agents, Tricyclic; D018491:Dopamine Agonists; D009125:Muscle Relaxants, Central; D000639:Amitriptyline; D001971:Bromocriptine; D003620:Dantrolene