Treatment of severe amitriptyline intoxication with plasmapheresis

Kolsal, Ebru; Tekin, İshak Özel; Pişkin, Etem; Aydemir, Cumhur; Akyüz, Mehmet Deniz; Çabuk, Hasan; Eldeş, Nilüfer; Numanoğlu, Varım

doi:10.1002/jca.20185

Cited by 21 publications

(10 citation statements)

References 4 publications

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“…In patients in whom no response to certain and traditional treatments is obtained, improvement with plasmapheresis occurs (2,3,4). In native and foreign publications, it has been reported that plasmapheresis is efficient in life-threatening tricyclic antidepressant (amitriptyline) intoxications in children (2,3,4,8,9,10). The consciousness opened after plasmapheresis in our patients whose Glascow coma scores were found to be 4 at presentation.…”

Section: Discussionmentioning

confidence: 52%

Ağır amitriptilin zehirlenmesi ve plazmaferez

...

2012

Tpa

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Sum maryTricyclic antidepressant intoxication is one of the most frequently seen and life-threatening causes of intoxication among referrals to emergency departments because of drug intoxication. Especially in children, it is a major cause of mortality and morbidity. Intoxication symptoms are observed in the early phase because of a high volume of distribution and a high degree of plasma protein binding. Plasmapheresis is very effective in poisonings with amitriptyline, theophylline, diltiazem, carbamazepine, L-thyroxin, verapamil and heavy metals including mercury. American Apheresis Association Guide recommends plasmapheresis to support primary treatment in drug poisonings which do not respond to certain and traditional treatments. In this report, we wanted to emphasize that plasmapheresis treatment was successful in two subjects who presented with amitriptyline intoxication. (Turk Arch Ped 2012; 47: 214-215)

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Section: Discussionmentioning

confidence: 52%

Ağır amitriptilin zehirlenmesi ve plazmaferez

...

2012

Tpa

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“…From the initial 1312 studies obtained, 77 studies met the inclusion criteria, including 1 observational study , 5 animal studies , 4 in vitro studies , 4 pharmacokinetic (PK) studies , and 63 case reports , 39 of which had sufficient toxicokinetic (TK) data. In total, 108 patients were included for analysis.…”

Section: Resultsmentioning

confidence: 99%

Extracorporeal Treatment for Tricyclic Antidepressant Poisoning: Recommendations from the EXTRIP Workgroup

Yates

Galvão

Sowinski

et al. 2014

Seminars in Dialysis

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The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.

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“…In patients with life threatening amitriptyline intoxication successful results had been reported with plasma exchange had been (7,(18)(19)(20)(21). Recently one study reported successful result with extended high cut-off dialysis (9).…”

Section: Discussionmentioning

confidence: 99%

A Case of Severe Amitriptyline Intoxication: Electrocardiography Signs Suggesting Ventricular Tachycardia

Keskin¹,

Laloğlu²,

Yalçınöz³

et al. 2016

West Indian Med J

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Amitriptyline poisoning may result in severe neurological and cardiac problems. We report a case of (13-month girl) severe amitriptyline intoxication with neurological, respiratory and electrocardiographic findings. With respiratory support, seizure control, NaHCO 3 infusion, intravenous lipid infusion, selective plasma exchange and arrhythmia control the patient recovered. We stressed that amitriptyline intoxication may lead to severe problems. Electrocardiographic findings may not be differentiated from ventricular tachycardia. In these patients, survey may be well with aggressive treatment modalities.

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Treatment of severe amitriptyline intoxication with plasmapheresis

Cited by 21 publications

References 4 publications

Ağır amitriptilin zehirlenmesi ve plazmaferez

Ağır amitriptilin zehirlenmesi ve plazmaferez

Extracorporeal Treatment for Tricyclic Antidepressant Poisoning: Recommendations from the EXTRIP Workgroup

A Case of Severe Amitriptyline Intoxication: Electrocardiography Signs Suggesting Ventricular Tachycardia

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