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Effects of self poisoning with maprotiline
British Medical Journal (Clinical Research Ed.)
|February 25, 1984
Summary
Maprotiline self-poisoning can cause severe cardiotoxicity and seizures, similar to tricyclic antidepressants. Physostigmine use in maprotiline overdose increases seizure risk and is not recommended.
Area of Science:
- Clinical Toxicology
- Pharmacology
Background:
- Maprotiline is a tetracyclic antidepressant.
- Overdosage of antidepressants can lead to severe toxicity.
Purpose of the Study:
- To investigate the clinical effects and outcomes of maprotiline self-poisoning.
- To compare maprotiline cardiotoxicity and seizure risk with conventional tricyclic antidepressants.
Main Methods:
- Retrospective study of 41 patients (43 episodes) admitted to intensive care unit following maprotiline self-poisoning.
- Analysis of clinical data including consciousness level, cardiorespiratory events, QRS interval, seizures, and treatment interventions.
Main Results:
- Maprotiline overdosage is associated with significant cardiotoxicity (QRS interval ≥ 100 ms in 28 patients) and seizures (15 patients).
- Cardiotoxicity is comparable to conventional tricyclic antidepressants.
- Seizure incidence is higher with maprotiline than with tricyclic antidepressants.
- Physostigmine administration precipitated seizures in 6 patients and should be avoided.
Conclusions:
- Maprotiline self-poisoning presents serious risks, including cardiotoxicity and a high incidence of seizures.
- Physostigmine exacerbates seizure risk in maprotiline overdose and should not be administered.