Relationship between clinical features of tricyclic antidepressant poisoning and plasma concentrations in children.

Crome, Peter; Braithwaite, R. A.

doi:10.1136/adc.53.11.902

Cited by 19 publications

(2 citation statements)

References 9 publications

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“…From these 45 articles, 27 more were excluded: 10 because the 2Â 2 tables could not be reconstructed, 2 because they only discriminated between TCA positive and TCA negative patients, 4 because they were reported as abstracts or published in duplicate, and 11 because the definitions of the outcome and the criteria used were ambiguous (Table 1). In 7 studies that evaluated multiple outcomes, the 2 Â 2 tables could not be reconstructed for some outcomes but could be reconstructed for others (Tables 1 and 2) (3,4,7,9,(16)(17)(18). From the remaining 11 studies (Table 2), data extraction was possible for all outcomes.…”

Section: Resultsmentioning

confidence: 99%

A Meta‐Analysis of Prognostic Indicators to Predict Seizures, Arrhythmias or Death After Tricyclic Antidepressant Overdose

Bailey

Buckley

Amre

2004

Journal of Toxicology: Clinical Toxicology

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Section: Resultsmentioning

confidence: 99%

A Meta‐Analysis of Prognostic Indicators to Predict Seizures, Arrhythmias or Death After Tricyclic Antidepressant Overdose

Bailey

Buckley

Amre

2004

Journal of Toxicology: Clinical Toxicology

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“…[108,109] Adverse effects commonly seen with the TCAs include dry mouth, urinary hesitance/retention, blurred vision and constipation, all due to the anticholinergic effects of these agents. [109] Increased heart rate and mild prolongation of intracardiac conduction are also often noted.…”

Section: Adverse Effectsmentioning

confidence: 99%

Pharmacological Treatment of Depression in Children and Adolescents

1999

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Major depression is a common disorder during childhood and adolescence. Over the past decade, many new antidepressants have been marketed in the US. In adults, these newer agents have been shown to be as effective as the prototypic tricyclic antidepressants (TCAs). Further, when compared with the TCAs these medications are better tolerated and are safer in overdose. Although TCAs are effective in the treatment of depressed adults, controlled clinical trials have not demonstrated their efficacy in either children or adolescents. In addition, concerns about the safety of TCAs and the monoamine oxidase inhibitors has left disappointingly few pharmacological treatment options available for depressed children and adolescents. For this reason, clinicians have begun to prescribe the newer agents for this population, despite the fact that relatively little is known about their disposition, safety or effectiveness in the young. Investigators have begun to examine whether the use of newer antidepressant medications such as fluoxetine, sertraline, paroxetine, fluvoxamine, nefazodone, and venlafaxine is truly indicated for children and adolescents with major depression. Pharmacokinetic studies of sertraline, paroxetine and nefazodone have been performed in depressed youths. The results of these studies have provided data for rational administration strategies for these agents. They have also provided evidence that these agents may be well tolerated in children and adolescents. Further evidence that these agents are often well tolerated when prescribed to depressed youths has been obtained from both open-label and double-blind studies. Published studies have generally shown that open-label treatment with these newer agents often leads to symptom amelioration in paediatric patients with major depression. Since high rates of placebo response are often seen in depressed children and adolescents, results from these studies cannot be interpreted to suggest that these medications have true antidepressant efficacy in this population. At present, the results of only two such studies have been published. The results of one of these trials are difficult to interpret because of methodological considerations. The other study reported that treatment with fluoxetine was superior to placebo. This paper critically reviews what has been published about the pharmacological treatment of depressed paediatric patients and provides some guidance to the use of antidepressants in this patient population, paying particular attention to what is known about the newer antidepressants as well as considering directions for future research.

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Tricyclic Antidepressant Plasma Levels in Overdose

Rudorfer¹

1981

JAMA

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hazards for our epileptic patients to avoid, we would indeed be, to them, the voice of doom. I, too, had a patient, a pretty young teenager with uncontrolled photosensitive seizures, die in a bathtub. When the police arrived to investigate, not a word was said by any family member about the existence of a seizure disorder, and so, for a time at least, the death was a total mystery to authorities. The mystery was cleared up when I saw word of her death in the newspaper and contacted the local medical examiner with the information he needed to close the case. For most patients with reasonable prospects for com¬ plete control, or for having but infre¬ quent seizures, it should suffice to warn them about the dangers of swimming, driving, and heights. Oth¬ er potential dangers might have to be voiced to patients in whom reasonable control can never be accomplished.

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Relationship between clinical features of tricyclic antidepressant poisoning and plasma concentrations in children.

Cited by 19 publications

References 9 publications

A Meta‐Analysis of Prognostic Indicators to Predict Seizures, Arrhythmias or Death After Tricyclic Antidepressant Overdose

A Meta‐Analysis of Prognostic Indicators to Predict Seizures, Arrhythmias or Death After Tricyclic Antidepressant Overdose

Pharmacological Treatment of Depression in Children and Adolescents

Tricyclic Antidepressant Plasma Levels in Overdose

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