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Coma blisters, peripheral neuropathy, and amitriptyline overdose: a brief report
Sheilagh Maguiness1, Lyn Guenther, David Shum
1University of Western Ontario, London, Ontario, Canada.
Journal of Cutaneous Medicine and Surgery
|November 26, 2002
Summary
Coma blisters, rare in amitriptyline overdose, may link to neuropathy. Amitriptyline overdose can cause microvascular damage, leading to coma, blisters, and neuropathy.
Area of Science:
- Toxicology
- Dermatology
- Neurology
Background:
- Coma blisters are typically linked to barbiturate and benzodiazepine overdoses.
- However, they have been observed with other substances, including amitriptyline.
Observation:
- This study reviews clinical manifestations of coma blisters in amitriptyline overdose.
- Case reports and literature reviews were utilized.
Findings:
- Coma blisters associated with amitriptyline overdose are infrequently documented.
- Peripheral neuropathy was present in two of four reported cases.
Implications:
- Amitriptyline impairs endothelial cell tight junction integrity.
- Overdose may predispose individuals to microvascular damage in a comatose state.
- This could explain the triad of coma, blisters, and neuropathy.