Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication
Journal of Experimental and Clinical Medicine (Turkey), cilt.38, sa.1, ss.43-46, 2021 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 38 Sayı: 1
- Basım Tarihi: 2021
- Doi Numarası: 10.5835/jecm.omu.38.01.009
- Dergi Adı: Journal of Experimental and Clinical Medicine (Turkey)
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, EMBASE
- Sayfa Sayıları: ss.43-46
- Anahtar Kelimeler: Coma, Dysrhythmia, Emulsion, Intoxication, Lipid, Treatment, Tricyclic antidepressant
- Ondokuz Mayıs Üniversitesi Adresli: Evet
Özet
An overdose of amitriptyline has neurological and cardiovascular side effects (psychosis, lethargy, coma, hypotension, and dysrhythmia). A 19-year-old female patient was admitted to our emergency service after a suicide attempt by amitriptyline ingestion of unknown amount. Her follow-up demonstrated deteriorating consciousness and vital signs, she had a generalized tonic-clonic seizure, and her electrocardiogram (ECG) revealed QRS interval widening followed by a ventricular tachycardia (VT) attack. The patient was treated with intravenous (IV) diazepam (Diazem®) to control the epileptic seizure, IV lidocaine (Aritmal®) to stop the VT attack, and IV sodium bicarbonate due to QRS interval widening. The patient was given norepinephrine bitartrate (Steradine®) and dopamine hydrochloride (Dopamine®) due to low blood pressure. Intravenous lipid emulsion (ILE) therapy was started due to the uncontrolled rhythm and hypotension. Here, we present a case report of a comatose patient with dysrhythmia due to amitriptyline overdose who responds to ILE therapy.