Intoxication by tricyclic antidepressant drugs: experimental study and therapeutic considerations
van de Ree, J.K.; Zimmerman, A.N.; van Heijst, A.N.
Netherlands Journal of Medicine 20(4-5): 149-155
1977
ISSN/ISBN: 0300-2977 PMID: 927613 Document Number: 113965
Since the mechanism of intoxication with tricyclic antidepressant agents cannot be elucidated on the basis of the clinical course, an experimental study was undertaken in dogs. Shock in intoxication with tricyclic antidepressants was primarily due to loss of myocardial contractility. The standard clinical parameters used for evaluation and treatment of shock are not clearly related to the extent of cardiac impairment, due to peripheral compensating mechanisms. Imipramine produced prolongation of the pulse-response time, an increase in stimulation threshold and a loss of voltage. Activation changes, arrhythmias and conduction disorders manifested themselves especially at a supraventricular level. Gastric lavage should be carried out in any case of intoxication with tricyclic antidepressants. There are no effective measures available to treat the cardiovascular complications.