Related Experiment Videos
Generalized convulsions as the presenting sign of amoxapine intoxication
Insights
Two infants experienced seizures or coma after ingesting amoxapine, a new antidepressant. Unlike older patients, infants showed central nervous system toxicity, not cardiotoxicity or anticholinergic effects.
Area of Science:
- Pediatric Toxicology
- Neuropharmacology
- Clinical Chemistry
Background:
- Amoxapine is a tetracyclic antidepressant recently introduced for adult use.
- Infant poisoning cases are rare, and their toxicological profiles may differ from adults.
Observation:
- Two infants presented with unexplained seizures or coma.
- Toxicological screening identified amoxapine in both infants' gastric contents.
- One infant had elevated serum amoxapine concentrations, while the other did not.
Findings:
- Infants primarily exhibited central nervous system toxicity (seizures, coma).
- No significant cardiotoxic or anticholinergic effects were observed in the affected infants.
- Amoxapine pharmacokinetics in infants were described, noting differences in serum concentration.
Implications:
- Infant amoxapine overdose presents with CNS toxicity, distinct from adult tricyclic antidepressant overdose symptoms.
- This highlights the need for specific pediatric toxicological monitoring and treatment protocols.
- Further research into infant pharmacokinetics and toxicity of newer antidepressants is warranted.
Abstract:
Two infants presented for medical evaluation with sudden onset of seizures or coma, without obvious cause. Suspicious circumstances led to toxicological screening analysis. Amoxapine, a recently released antidepressant, was found in the gastric contents of both children an undetermined time after the putative ingestion, but elevated serum concentrations were noted only in one. The pharmacokinetics are described. There were no obvious cardiotoxic or anticholinergic effects in these infants. Thus, they, like older children and adults, manifest mainly central nervous system toxicity rather than the cardiotoxicity and anticholinergic effects of overdose seen with tricyclic antidepressants.