Amitriptyline (Imizin and Other Tricyclic Antidepressants)

Amitriptyline (Imizine and other tricyclic antidepressants)

Amitriptyline belongs to the group of tricyclic antidepressants. It has selective psychotropic, neurotoxic (anticholinergic, antihistamine), cardiotoxic effects.

In mild poisoning, symptoms such as dry mouth, blurred vision, psychomotor agitation, weakened intestinal motility, urinary retention, muscle twitching and hyperkinesis are observed.

In severe poisoning, confusion of consciousness up to deep coma and attacks of clonic-tonic convulsions of the epileptiform type develop. Cardiac dysfunctions are observed: tachycardia, rhythm and conduction disturbances (up to complete atrioventricular block and ventricular fibrillation). The development of acute cardiovascular failure and collapse is possible.

Complications of severe poisoning can include toxic hepatopathy, hyperglycemia, and intestinal paresis. Lethal dose - over 1.5 g.

Treatment includes gastric lavage, administration of activated carbon and laxatives, forced diuresis, and in severe poisoning - hemosorption. To relieve rhythm disturbances, prozerin, physostigmine, inderal, lidocaine, and atropine are used. For convulsions and agitation, diazepam is prescribed. ECG monitoring is required. Cardiac glycosides are contraindicated.