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J Emerg Med. 2012 Sep;43(3):465-7. doi: 10.1016/j.jemermed.2011.09.010. Epub 2012 Jan 12.

"Lipid rescue" for tricyclic antidepressant cardiotoxicity.

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1
Department of Cardiology, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.

Abstract

BACKGROUND:

Tricyclic antidepressant (TCA) toxicity results predominantly from myocardial sodium-channel blockade. Subsequent ventricular dysrhythmias, myocardial depression, and hypotension cause cardiovascular collapse. Animal studies have demonstrated the effectiveness of intravenous lipid-emulsion in treating TCA cardiotoxicity.

CASE REPORT:

We report a case of dothiepin (tricyclic antidepressant) overdose causing refractory cardiovascular collapse, which seemed to be successfully reversed with lipid-emulsion therapy (Intralipid(®); Fresenius, Cheshire, UK).

CONCLUSIONS:

Lipid emulsions are a potentially novel therapy for reversing cardiotoxicity seen in TCA overdose. Research is required into the role of lipid emulsion in the management of poisoning by oral lipophilic agents.

PMID:
22244291
DOI:
10.1016/j.jemermed.2011.09.010
[Indexed for MEDLINE]
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