Recognition and management of antidepressant overdoses: tricyclics and trazodone

Serious overdoses associated with tricyclic and tetracyclic antidepressants are frequently lethal. Problems associated with tricyclic antidepressant overdoses are usually the result of an acute or an acute-on-chronic overdosage. The patient who overdoses on tricyclic antidepressants may die, despite every medical effort to save him. An overdose of trazodone significantly differs from an overdose of a tricyclic antidepressant. The currently available clinical data indicate that coma and hypotension are the main concerns with trazodone overdose, and heretofore have been successfully treated with lavage, fluid therapy, and observation.