Charcoal haemoperfusion in a child with amitriptyline poisoning.

Tricyclic antidepressant (TCA) overdose is a relatively common cause of poisoning. According to the American Association of Poison Control Centers, 7961 patients with amitriptyline poisoning were reported in 2000. Of these, 958 were under 6 years old, 6388 needed treatment in a health care facility and 68 patients died [1]. The current therapy of TCA overdose includes preventive measures such as gastric lavage, activated charcoal, anticonvulsants, vasopressors for hypotension, and sodium bicarbonate infusion for dysrhythmias [2,3]. Although charcoal haemoperfusion (CHP) has been used in the management of amitriptyline overdose, the data regarding CHP in the management of amitriptyline overdose is controversial [3–5]. To our knowledge, there is no report related to the use of CHP in children with amitriptyline poisoning in the English literature. Here, we report a child with amitriptyline poisoning who showed dramatic improvement after CHP treatment.