Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Videos

Prolonged clinical effects in modified-release amitriptyline poisoning.

Niall O'Connor¹, Shaun Greene, Paul Dargan

¹Emergency Department, Guys and St. Thomas' NHS Trust, London, UK. Niall.OConnor@maile.hse.ie

Clinical Toxicology (Philadelphia, Pa.)

|February 25, 2006

Summary

Prolonged tricyclic antidepressant toxicity can occur with modified-release amitriptyline overdose, lasting up to 4 days. Multidose activated charcoal and sodium bicarbonate aided recovery in a severe case.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Quality improvement: prevention of cardiac arrest in children with heart disease on the paediatric intensive care unit.

BMJ paediatrics open·2026

Same author

Clinicians' attitudes to the West Midlands damage control surgery pathway for severe necrotising enterocolitis.

Archives of disease in childhood. Fetal and neonatal edition·2026

Same author

Novel benzodiazepines in illicit drug use: sentinel emergency department data do not indicate disproportionate clinical harm.

The International journal on drug policy·2026

Same author

Management of patients with suspected but unidentified poisoning in the emergency department: a joint Royal College of Emergency Medicine and National Poisons Information Service best practice guideline.

Emergency medicine journal : EMJ·2026

Same author

Retrospective cohort analysis of nitrite and nitrate levels in postmortem biological samples after suspected suicide, 2019-24.

BMJ public health·2026

Same author

Quantification of Macular Carotenoids over a Wide Dynamic Range in Plant Matrices and Caco-2 Cells Using a Single Transferable Analytical Method.

Foods (Basel, Switzerland)·2026

Area of Science:

Toxicology
Emergency Medicine
Pharmacology

Background:

Tricyclic antidepressant (TCA) poisoning presents significant cardiovascular and central nervous system toxicity.
Standard treatment involves gastric decontamination, sodium bicarbonate, and supportive care.
TCA toxicity typically resolves within 24-48 hours post-ingestion.

Observation:

A case of severe TCA poisoning involving modified-release amitriptyline is presented.
Significant clinical toxicity, including QRS prolongation and metabolic acidosis, persisted for up to 4 days.
The patient ingested a modified-release preparation of amitriptyline.

Findings:

Successful recovery was linked to multidose activated charcoal and repeated intravenous sodium bicarbonate.

Related Experiment Videos

These interventions were crucial for managing prolonged toxicity.

The case highlights the effectiveness of aggressive decontamination in severe TCA overdose.

Implications:

Clinicians must recognize the potential for extended TCA toxicity with modified-release formulations.
Consider aggressive gastric decontamination, including multidose activated charcoal and whole bowel irrigation, for prolonged absorption or toxicity.
These interventions may be necessary for over 36 hours post-ingestion.