Tricyclic antidepressants toxicity & tx
Sedation, α1-blocking effects including postural hypotension, and atropine-like (anticholinergic)side effects (tachycardia, urinary retention, dry mouth). 3° TCAs (amitriptyline) have more anticholinergic effects than 2° TCAs (nortriptyline). Can prolong QT interval.
Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmias); also respiratory depression,hyperpyrexia. Confusion and hallucinations in elderly due to anticholinergic side effects (usenortriptyline). Treatment: NaHCO3 to prevent arrhythmia.