What happens when you overdose on tricyclics?
Tricyclic antidepressant overdose is poisoning caused by excessive medication of the tricyclic antidepressant (TCA) type. Symptoms may include elevated body temperature, blurred vision, dilated pupils, sleepiness, confusion, seizures, rapid heart rate, and cardiac arrest.
How does TCA overdose cause death?
Severe TCA overdose commonly causes fatal arrhythmia and myocardial depression due to blockade of sodium channels. This results in refractory hypotension, which is the commonest cause in death in TCA overdose [1, 2].
Which tricyclic antidepressants is most dangerous in overdose?
All widely used tricyclic antidepressants (TCAs) except clomipramine and lofepramine appear to be dangerous in overdose, whereas the newer antidepressants such as mianserin, trazodone, viloxazine and the TCA lofepramine appear to be relatively safe.
What is the cause of tricyclic antidepressant overdose?
Tricyclic antidepressant overdose. Tricyclic antidepressant overdose is poisoning caused by excessive medication of the tricyclic antidepressant (TCA) type.
How can a TCA overdose cause cardiac toxicity?
TCAs can cause cardiac toxicity. Blockade of fast sodium channels in myocardial cells slows the action potential and provides a membrane stabilizing effect. The characteristic QRS prolongation seen in TCA overdose occurs secondary to prolongation of phase “0” of the myocardial action potential.
Is there a role for physostigmine in tricyclic overdose?
Physostigmine is a short acting cholinesterase inhibitor that was proposed in the 1970s as a treatment for arrhythmias. Since then, however, it has been described as causing asystole 72 and seizures. 73 There is no role for its use in the management of tricyclic toxicity.
Which is more common, SSRI or TCA overdose?
According to the database, TCA overdose accounted for 1.12 exposures per 10,000 population in 1992. Recently, the trend for antidepressant overdose has shifted more towards SSRIs. However, the rate of hospitalization is higher in cases of TCA overdose compared to SSRI, because of the narrower therapeutic index with TCAs.