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Related Experiment Videos

Amitriptyline poisoning in a 2-year old.

Catherine Deegan1, Kay O'Brien

  • 1Department of Anaesthesia and Intensive Care Medicine, Children's University Hospital, Temple Street, Dublin 1, Ireland.

Paediatric Anaesthesia
|January 25, 2006
PubMed
Summary

A 2-year-old boy survived a severe amitriptyline overdose with coma and cardiac arrest after prolonged cardiopulmonary resuscitation. Aggressive management led to full recovery, highlighting the importance of extended resuscitation in poisoning cases.

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Area of Science:

  • Toxicology
  • Pediatric Emergency Medicine
  • Cardiology

Background:

  • Amitriptyline (tricyclic antidepressant) overdose can cause life-threatening central nervous system and cardiac toxicity.
  • Pediatric ingestions require careful monitoring and management due to potential for rapid deterioration.

Observation:

  • A 2-year-old boy ingested a significant dose (35 mg/kg) of amitriptyline.
  • The patient experienced rapid onset of coma, seizures, and cardiac arrest within 1 hour.
  • Cardiac rhythm instability persisted for 17 hours, refractory to standard treatments.

Findings:

  • Prolonged and aggressive cardiopulmonary resuscitation (CPR) was crucial for survival.
  • The patient achieved complete neurological and cardiovascular recovery.

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  • Post-recovery echocardiogram and MRI of the brain were normal.

    • Implications:

    • This case underscores the critical role of extended, effective CPR in managing severe tricyclic antidepressant poisoning in children.
    • Aggressive supportive care can lead to favorable outcomes even in seemingly dire poisoning scenarios.
    • Highlights the need for prompt and intensive medical intervention for pediatric amitriptyline overdose.