Tricyclic antidepressant poisoning

Tricyclic antidepressants are a group of antidepressants named after their chemical structure.

The most common cause of intoxication is accidental or with autolytic ideas. Excessive intake is toxic and even fatal.

Initially, they cause confusion, seizures, hallucinations, dry skin and mucous membranes, and urinary retention. After a few hours, there are more severe complications such as arrhythmias, hypotension, seizures and coma. Therefore, an urgent consultation is required for hospital admission, even initial care by an ambulance (EMS).

Diagnosis is made based on clinical history and physical examination. It is confirmed through a blood test.

The patient should be hospitalised for continuous monitoring of vital signs. In the first hours, gastric lavage to limit drug absorption and, depending on the severity, supportive measures up to intubation may be useful. Evaluation by a psychiatrist is always necessary.