Treatment of severe imipramine poisoning complicated by a negative history of drug ingestion

Seizures associated with poisoning in children: tricyclic antidepressant intoxication

“…Cardiovascular effects are not dose dependent 1–3,10 . The most serious signs are ventricular arrhythmia and cardiac arrest 7,13–15 . Life‐threatening cardiotoxicity results from TCA‐induced inhibition of sodium influx through voltage‐gated sodium channels 1–3,10 .…”

“…1 -4 Tricyclic antidepressant overdose poisonings are one of the most commonly encountered causes of intoxications in regard to fatality. 1,2,5,7,11 The most severe signs and symptoms are related to central nervous system and cardiovascular system. 6,7,11,12 Plasma tricyclic levels correlate poorly with severity of disease and prognosis.…”

“…Four to six percent of all children will have at least one seizure episode before the age of 16 years 3 . Epilepsy, febrile seizure, trauma, infection and metabolic problems are the most frequent causes of seizures; 3 toxins are among other causes of seizures 1–8 . Seizures due to metabolic causes (hyponatremia, hypoglycemia) are resistant to anticonvulsive drugs 1–4 .…”

“…It is very important to follow up these patients carefully. Intoxications with β‐blockers, TCA, carbon monoxide, INH, lead, cocaine, theophylline, lithium, diphenhydramine, meperidine, organophosphate/carbamate, volatile substances (camphore, eucalyptus) may cause seizures 1,2,5,7–9 . Olson et al had investigated seizures due to intoxications at an intoxication center and found that TCA, cocaine and other stimulants are the most frequent agents 4 .…”

“…Every year, millions of children are treated in emergency rooms with the diagnosis of intoxication 1,2 . One of the serious clinical conditions due to intoxication that may appear is seizure 1–7 . It is hard to diagnose a seizure associated with poisoning if there is no history of intoxication.…”