Amitriptyline Poisoning

Abstract

In recent years there has been a marked increase in the introduction and use of psychopharmacological agents in clinical medicine. One of the newer drugs, amitriptyline hydrochloride (Elavil), 5-(3-dimethylaminopropylidene)-dibenzo [a,d] [1,4] cycloheptadiene hydrochloride, structurally and pharmacologically resembles imipramine (Tofranil), an antidepressant with anticholinergic, antihistaminic, and tranquilizing properties.^1,7Both drugs have had favorable therapeutic results and have therefore experienced rapid, widespread clinical usage.^1-3The two drugs differ pharmacologically from other psychotherapeutic compounds in that they are not monoamineoxidase inhibitors 4 (Figure). The purpose of this communication is (1) to present the symptoms and postmortem findings in an infant who died after the accidental ingestion of a massive amount of amitriptyline hydrochloride and also (2) to report the ineffectiveness of peritoneal dialysis in removing the ingested drug. Report of a Case A 15-month-old white female was admitted to the Stanford Medical Center Emergency Room in June 1961, approximately 45 minutes