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Tricyclic antidepressant plasma levels and adverse effects after overdose
Author(s) -
Petit James M.,
Spiker Duane G.,
Ruwitch Joseph F.,
Ziegler Vincent E.,
Weiss Alan N.,
Biggs John T.
Publication year - 1977
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt197721147
Subject(s) - tricyclic , tricyclic antidepressant , qrs complex , medicine , adverse effect , anesthesia , antidepressant , plasma concentration , plasma levels , cardiology , pharmacology , hippocampus
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 < 0.00l), 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.