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Management of tricyclic antidepressant poisoning 

Management of tricyclic antidepressant poisoning
Chapter:
Management of tricyclic antidepressant poisoning
Author(s):

Giorgio Berlot

and Ariella Tomasini

DOI:
10.1093/med/9780199600830.003.0321
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date: 01 August 2021

Tricyclic antidepressants (TCAs) are still prescribed worldwide for the treatment of major depression and other disorders. Unfortunately, the safety margin of these agents is rather narrow and TCA-related intoxication is associated with a number of potentially life-threatening side effects. The symptoms being rather unspecific, a high index of suspicion is warranted in order to identify promptly the intoxicated patients and to provide the appropriate care, even before the detection and dosage of TCAs and related metabolites in the blood and/or urine. In the absence of a specific antidote, the treatment basically consists in the support of ventilation in comatose patients, the correction of arterial hypotension, the treatment of arrhythmias, and the enhancement of renal excretion of TCAs.

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