Amoxapine overdose. Seizures and fatalities

Area of Science:

• Clinical Toxicology
• Pharmacovigilance

Background:

• Cyclic antidepressants are common overdose agents.
• Amoxapine is a less frequently reported cyclic antidepressant.

Purpose of the Study:

• To compare the toxicity of amoxapine overdose with other cyclic antidepressants.
• To determine the mortality and morbidity rates associated with amoxapine overdose.

Main Methods:

• Retrospective case series analysis.
• Data collected from two regional poison centers over 18 months.
• Comparison of amoxapine overdose outcomes with other cyclic antidepressant overdoses.

Main Results:

• Thirty-three amoxapine overdoses reported, with a 15.2% mortality rate.
• Amoxapine overdose mortality is significantly higher than other cyclic antidepressants (15.2% vs. 0.7%).
• Seizure incidence was 36.4% in amoxapine overdoses, versus 4.3% in others.

Conclusions:

• Amoxapine is associated with a disproportionately high rate of mortality and seizures.
• Amoxapine overdose presents a greater risk than other cyclic antidepressants.
• Increased vigilance and specific treatment protocols for amoxapine overdose are warranted.