Tricyclic antidepressant overdose in a toddler treated with intravenous lipid emulsion.

Abstract

We report a case that involves the use of intravenous lipid emulsion as an antidote for a drug overdose involving a 20-month-old girl who had ingested a potentially lethal amount of the tricyclic antidepressant (TCA) dothiepin. The patient's condition continued to deteriorate despite implementation of standard pediatric treatment recommendations for TCA toxicity. Administration of intravenous lipid emulsion in addition to standard therapy (including sodium bicarbonate) and direct-current cardioversion for ventricular arrhythmia led to a successful outcome. The case report is followed by a review of the current evidence underlying this novel therapy and the background on its use. TCA toxicity is addressed specifically.

• Authors: David Hendron, Gareth Menagh, Euan A Sandilands, Damian Scullion
• Journal: Pediatrics (Pediatrics) Vol. 128 Issue 6 Pg. e1628-32 (Dec 2011) ISSN: 1098-4275 [Electronic] United States
• PMID: 22065274 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antidepressive Agents, Tricyclic
• Fat Emulsions, Intravenous
• Dothiepin

Topics

• Antidepressive Agents, Tricyclic (poisoning)
• Dothiepin (poisoning)
• Drug Overdose (therapy)
• Fat Emulsions, Intravenous (therapeutic use)
• Female
• Humans
• Infant