Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University
EMERGENCY MEDICINE BLOCK
ANTIDEPRESSANT
POISONING
ANTIDEPRESSANT POISONING
ANTIDEPRESSANT
Trycyclic antidepressants (amitryptiline,
desipramine, doxepin)
Anticholinergic symptoms (tachycardia, dilated pupils,
dry mouth)
Strong alpha blocker vasodilation
Agitation and seizures, then depression and
hypotension
Slowed conduction with wide QRS interval, depressed
cardiac contractility
Treatment : supportive care, ETT, IV fluid, dopamine
and norepinephrine, antidote for cardiac toxicity :
sodium bicarbonate. Do not use physostigmine
Katzung Basic & Clinical Pharmacology 11th Ed
ANTIDEPRESSANT
Monoamine oxidase inhibitors (phenelzine)
Severe hypertensive reation
Interact with SSRI
Newer Antidepresants (fluoxetine, paroxetine,
citalopram)
Cause seizures
QT prolongation and torsade de pointes
Interact with MOA serotonin syndrome (muscle
hyperactivity, hyperthermia)
Katzung Basic & Clinical Pharmacology 11th Ed