Related Experiment Video
Updated: May 18, 2026

Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
Published on: November 29, 2017
Amitriptyline cream ingestion in a 1-year-old boy
Nathalie S M Lak1, Mirte M Malingre, Paul H G Hogeman
1Meander Medical Centre, Ringweg Randenbroek 110, 3816 CP Amersfoort, the Netherlands.
Insights
Amitriptyline cream intoxication in a child caused drowsiness and cardiac issues. Prompt monitoring led to a full recovery within 24 hours, highlighting cream safety concerns.
Area of Science:
- Pediatric Toxicology
- Dermatology
- Clinical Case Reports
Background:
- Amitriptyline, an antidepressant and neuropathic pain medication, is typically administered orally.
- Topical amitriptyline cream represents a novel formulation with less established safety data, particularly in pediatric populations.
- Pediatric amitriptyline exposure can lead to severe systemic effects, including central nervous system and cardiovascular complications.
Abstract:
A 1-year-old boy presented to the emergency department with drowsiness after intoxication from amitriptyline cream. The amitriptyline level in his blood was in the high-therapeutic range for adults. He was admitted for cardiac monitoring. Except for a short episode with irregular heart rate, he recovered completely within 24 hours without adjuvant treatment. Amitriptyline is known as an antidepressant but is also prescribed for neuropathic pain. It is usually prescribed in tablet form; the cream is a novel application. In children, intoxication with amitriptyline may cause drowsiness, seizures, coma, hypotension, tachycardia, and life-threatening cardiac arrhythmias. This is the first case report presenting intoxication in a child with amitriptyline cream. It stresses the importance of keeping children away from the medicine cabinet, even from creams or ointments.
Related Concept Videos
Drug Dosing: Infants and Children
Pharmacokinetics in Pediatric Patients: Drug Excretion
Pharmaceutical Poisoning: Treatment Strategies
Anticholinesterase Agents: Poisoning and Treatment
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Prevention of Further Absorption of Poison
