Imipramine
Amitriptyline
Doxepin
Nortriptyline
Protriptyline
Trimipramine
- Discussion:
-
anticholinergic crisis in w/ antidepressant overdose presents as:
- mydriasis, blurred vision, urinary retension, dry mucous membranes,
constipation, ileus, sinus tachycardia, hyperthermia or hypothermia,
confusion, agitation, and hallucinations;
-
acidosis potentiates TCA toxicity;
- respiratory acidosis is treated w/ intubation and hyperventilation;
-
drug interactions:
-
anesthetic agents:
- combination of halothane, pancuronium, & tricyclic antidepressants,
can cause severe ventricular arrhythmias;
- interaction w/
neuroleptic agents,
- combination of drugs should be especially avoided in the elderly;
- least potent antipsychotics (
Chlorpromazine &
Thioridazine tend to
be most sedating and to have most
anticholinergic effects;
- use of such drugs in combination w/ antidepressant that also has
high anticholinergic activity may cause toxic anticholinergic
reactions, including delirium;
- autonomic side effects are also relatively frequent w/ less
potent neuroleptics, & resultant
hypotensive episodes may
predispose to falls, myocardial infarction, or CVA;
