Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1-2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been r...

Several investigators have recently developed guidelines for determining which patients with tricyclic antidepressant overdose should be hospitalized. The width of the QRS complex on the ECG and several clinical parameters have been proposed to identify patients at risk for major complications. To validate these, we developed an algorithm and then applied it to 45 patients who had overdosed on ...

neuroleptic malignant syndrome (nms) is a rare fatal medical complication that occurs as a result of dopaminergic receptor blockage in the caudate at the termination of the nigrostriatal pathways (1), and may occur at any time following consumption of dopamine antagonists. this disorder also occurs in cases of sudden discontinuation of dopamine agonists and antagonists (2,3). some studies have ...

Acrocyanosis is probably the most unusual side effect of tricyclic antidepressant drugs. In this paper, we report a 10-year-old boy with primary enuresis nocturna and attention deficit hyperactivity disorder who developed two episodes of acrocyanosis, the first of which was after imipramine treatment and the second after desipramine usage. We also review the possible pathogenesis of acrocyanosi...

With great interest I have read an excellent article " Evaluation of the efficacy of intrathecal injection of amitripty-line and doxepin in spinal anesthesia in comparison with bupivacaine in rats " , published in your respected journal. The authors present and elaborate a very interesting subject of the application of tricyclic antidepressants as a local anesthetic. I totally agree with the au...

Background. Psychiatric consultation is necessary for all patients with intentional poisoning and its reliability depends on the proper function of patients' memory performance. This study aimed to determine the possible memory impairment following acute TCAs' poisoning. Materials and Methods. In this cross-sectional study, patients with acute TCAs poisoning were allocated to two groups of seve...

The most common cause for adverse cardiac events by antidepressants is acquired long QT syndrome (acLQTS), which produces electrocardiographic abnormalities that have been associated with syncope, torsade de pointes arrhythmias, and sudden cardiac death. acLQTS is often caused by direct block of the cardiac potassium current I(Kr)/hERG, which is crucial for terminal repolarization in human hear...

GST pi, the main glutathione S-transferase isoform present in the human brain, was isolated from various regions of the brain and the in vitro effect of tricyclic antidepressants on its activity was studied. The results indicated that amitripyline and doxepin--derivatives of dibenzcycloheptadiene, as well as imipramine and clomipramine--derivatives of dibenzazepine, inhibit the activity of GST ...

There is a high prevalence of chronic pain disorders in the population and the individual and societal costs are large. Antidepressants have been used in the treatment of chronic pain and the pain-relieving effects are independent of the mood-elevating properties. We reviewed randomised-controlled trials, systematic reviews and meta-analyses of antidepressants in the treatment of chronic pain d...

Drugs used to facilitate sexual assaults are typically those that rapidly render the potential victim unconscious or sedated, and produce memory loss or amnesia. Many of these drugs are difficult to detect due to a delay in biological specimen collection. Detection is further hampered as the drugs are often administered in single low doses and are rapidly and extensively metabolized, resulting ...