Tricyclic antidepressant overdose: incidence of symptoms

Abstract

Consecutively hospitalized patients (40) who had overdosed primarily with a tricyclic antidepressant (TCA) were observed until discharge. The severity of the overdose was documented by serial measurements of plasma TCA levels. Of the patients, 19 became camatose, 16 required supportive respiration and 2 died. Individual symptoms in the 13 patients having plasma TCA levels greater than 1000 ng/ml are shown. Plasma TCA measurements more reliably define patients who are at risk for major medical complications following overdose than does the amount of drug ingested by history. In the absence of plasma measurements, a QRS duration of 100 ms or more on a routine ECG within the 1st 24 h defined all patients with major TCA overdoses.