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Abstract
Tricyclic antidepressant drugs are well known as classic medications not only for depression but also for other medical indications like nocturnal enuresis and chronic pain.
Although SSRI are widely prescribed nowadayas for treatment of depression but TCA still prescribed for severe forms of depression and because of their cheaper cost than SSRI.
484 patients with TCA overdose were included in this study.
The patients were recruited from the 1st of January 2000 to 31st of December 2007.
445 cases were admitted in the period from 1st of january 2000 to 31st of December 2006, the data of this group of patients were collected retrospectively.
39 cases were admitted in the period from 1st of January 2007 to 31st of December 2007, the data of this group of patients was collected prospectively.
Patients were subgrouped into 268 pateints ingested amitriptyline, 141 pateints ingested dothiepin and 75 patients ingested lofepramine.
These three drugs were the most prescribed TCAs in UK in the last decade.
At least one ECG was performed for each patient.
These ECGs were analysed manually by a validated computer software which was designed for this purpose.
Healthy volunteer group of 138 person was designed for comparison with patients groups.
Complete data were collected for each patient.
This research studied the effect of some risk factors (age, gender, ingested dose, mode of poisoning, alcohol ingestion, cardiovascular drug coingestion and sedative drug coingestion) on some intermediate toxicity parameters which included; GCS level, length of stay at hospital, QRS duration and blood pH.
Other important clinical presentations like ICU admission and endotracheal intubation were also included in the analysis.
The intermediate outcome toxicty parameters used in this study (GCS, Length of stay at hospital, QRS duration and blood pH) instead of the traditional complications usually encountered with TCA overdose (seizures, arrythmias and death) because these complications were not common in the current study.
male pateints were more than male pateints in all TCA overdose groups.