The clinical findings in three patients who ingested 260-900 mg cyclobenzaprine (Flexeril) consisted of delayed onset and long duration of anticholinergic symptomatology. In two of these patients, symptoms responded to treatment with physostigmine. The third patient recovered without specific therapy. Despite its structural similarity to amitriptyline, cyclobenzaprine overdosage did not result in coma, seizures, or cardiac toxicity. The pharmacological properties of cyclobenzaprine may account for the observed toxicity.
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