Beta-Blocker Treatment in an Adolescent With Amitriptyline Intoxication

Amitriptyline is one of the major tricyclic antidepressants (TCA) (1). Among the antidepressants, TCAs have been the most common poisons used in suicide (2). Tricyclic antidepressants poisoning results in hypotension, cardiac dysrhythmia, depression of the central nervous system (CNS) and seizures, and is a major cause of death by poisoning in the UK (3). The most common cause of death after TCA overdose is myocardial depression with refractory hypotension, ventricular tachycardia, or ventricular fibrillation (4). Current therapy includes vasopressors for hypotension, sodium bicarbonate for dysrhythmias, and benzodiazepines for seizures (3). We report a case of a child who was successfully treated with beta-blocker in severe amitriptyline intoxication.