Tricyclic antidepressant plasma levels and adverse effects after overdose

James M. Petit; Duane G. Spiker; Joseph F. Ruwitch; Vincent E. Ziegler; Alan N. Weiss; John T. Biggs

doi:10.1002/cpt197721147

Tricyclic antidepressant plasma levels and adverse effects after overdose

James M. Petit, Duane G. Spiker, Joseph F. Ruwitch, Vincent E. Ziegler, Alan N. Weiss, John T. Biggs

Division of Cardiology

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124 Scopus citations

Abstract

Forty patients ingesting tricyclic antidepressant (TAD) overdoses were studied as a pharmacologic model to determine whether total tricyclic antidepressant plasma levels correlated with major adverse effects and electrocardiographic findings. Maximum TAD plasma levels were higher in patients who died (p < 0.025) or had cardiac arrest (p < 0.02), needed respiratory support (p < 0.005), were unconscious (p < 0.02), had grand mal seizures (p < 0.001), ventricular rate ≥ 120/min (p < 0.01), cardiac arrhythmia (p < 0.05), QRS duration ≥ 100 msec (p < 0.001), or bundle branch block (p < 0.05). TAD plasma levels correlated with the dose ingested by history (N = 29, r = 0.58, p < 0.001). Measurement of total TAD (free and protein-bound) appears to correlate well with biologic response.

Original language	English
Pages (from-to)	47-51
Number of pages	5
Journal	Clinical pharmacology and therapeutics
Volume	21
Issue number	1
DOIs	https://doi.org/10.1002/cpt197721147
State	Published - Jan 1977

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abstract = "Forty patients ingesting tricyclic antidepressant (TAD) overdoses were studied as a pharmacologic model to determine whether total tricyclic antidepressant plasma levels correlated with major adverse effects and electrocardiographic findings. Maximum TAD plasma levels were higher in patients who died (p < 0.025) or had cardiac arrest (p < 0.02), needed respiratory support (p < 0.005), were unconscious (p < 0.02), had grand mal seizures (p < 0.001), ventricular rate ≥ 120/min (p < 0.01), cardiac arrhythmia (p < 0.05), QRS duration ≥ 100 msec (p < 0.001), or bundle branch block (p < 0.05). TAD plasma levels correlated with the dose ingested by history (N = 29, r = 0.58, p < 0.001). Measurement of total TAD (free and protein-bound) appears to correlate well with biologic response.",

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AU - Petit, James M.

AU - Spiker, Duane G.

AU - Ruwitch, Joseph F.

AU - Ziegler, Vincent E.

AU - Weiss, Alan N.

AU - Biggs, John T.

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Tricyclic antidepressant plasma levels and adverse effects after overdose

Abstract

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