Lipid rescue" for tricyclic antidepressant cardiotoxicity.

Michael Stephen Blaber, Jamal Nasir Khan, Judith Anne Brebner, Rachel McColm

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

The Journal of emergency medicine 2012 Sep

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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. 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). 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. Copyright © 2012 Elsevier Inc. All rights reserved.

Citation

Michael Stephen Blaber, Jamal Nasir Khan, Judith Anne Brebner, Rachel McColm. Lipid rescue" for tricyclic antidepressant cardiotoxicity. The Journal of emergency medicine. 2012 Sep;43(3):465-7