Showing 3 results for Tricyclic Antidepressants
Farzad Gheshlaghi, Nastaran Ezadi Mood,
Volume 1, Issue 3 (9-2007)
Abstract
Background: Tricyclic antidepressants (TCAS) Poisoning is the most common poisoning in the Poisoning Emergency Department of Noor Hospital, Isfahan, Iran. The objective of this study was to compare QRS interval duration with RaVR³3mm and R/SaVR³ 0.7 in predicting: serious complications of acute TCA toxicity.
Methods and Materials: This study was descriptive – analytic and prospective cohort. TCA poisoned patients (155 cases) were evaluated in the Emergency Department of Noor Hospital, Isfahan. On admission time, ECG and ABGs were done. Data were analyzed by SPSS Software, using t – students and chi- square tests.
Results: The ECG results showed that frequency of RaVR³3mm , R/SaVR³ 0.7 , QRS³0.1(s), QT> 0.48(s) , Right axis deviation and arrhythmia were 5.2% ,12.9% , 37.4% , 8.38% , 12.4% and 4.5 % respectively. There was a significant relationship between widening of QRS with arrhythmia RaVR³3mm with tachycardia and delirium and R/SaVR³ 0.7 with delirium, seizure, tachycardia, hypotension and arrhythmia. QRS interval duration (61.5% -85.7%) was found to be a more sensitive indicator of toxicity than the R/SaVR ³ 0.7 (27.1% -30.7%) and RaVR>3mm (7.6% -14.2%). The positive prodective values (PPV) of ECG parameters for TCA toxicity for R/SaVR ³0.7 (20%) was more than RaVR³3mm (12.5%) and widening QRS (10.3%).
Conclusion: Specific ECG parameters such as R/SaVR, QRS interval duration and height of the R wave in lead aVR can be useful parameters in assessing and predicting cardiac and CNS complication of TCA toxicity.
Hale Talaie, Mohammad Abdollahi, Abdolkarim Pajoumand, Reyhaneh Panahandeh, Behjat Barari, Maryam Baeeri,
Volume 2, Issue 3 (9-2009)
Abstract
Introduction: Pro-inflammatory cytokines, such as IL-1b and TNF- α have been suggested to be involved in the pathophysiology of depression. Tricyclic antidepressants (TCAs) are also thought to influence immune functions and concentrations of cytokines. The aim of this study was to evaluate the status of serum IL-1b and TNF-α in depressed patients who were treated, not treated, or poisoned with TCAs in comparison to healthy subjects.
Material & Methods: In this cross-sectional study, 40 patients who were admitted at Loghman-Hakim Hospital from August 2007 to January 2008 were selected. They were divided into 4 groups: healthy individuals, TCA-poisoned patients, TCA-treated depressed patients, and non-treated depressed patients with 10 subjects in each group. Serum level of IL-1b and TNF-α were compared between groups and demographic and clinical data were collected by a questioner filled out by a trained practitioner. Liver function tests, blood cell count, electrocardiography, and arterial blood gases were also performed.
Results: Complete blood analysis and demographic data showed significant differences between groups. IL-1b level was higher among females. The group of depressed patients non-treated with TCAs showed higher serum concentrations of IL-1b and TNF-α than other groups. No significant difference was observed in IL-1b and TNF-α values among healthy control, depressed TCA-treated, and TCA-poisoned groups.
Conclusion: Depression and gender may influence the production of cytokines while neither TCAs treatment nor its overdose affects IL-1b and TNF-α.
Haleh Talaie, Babak Mastafazadeh, Arezou Mahdavinejad, Reyhaneh Panahandeh,
Volume 2, Issue 3 (9-2009)
Abstract
Introduction: Tricyclic antidepressants (TCAs) are widely used in psychiatric and medical conditions and are a major cause of drug overdoses and fatal poisonings in many contries. Sodium bicarbonate administration is widely recommended as the first line treatment in TCAs intoxication but the best method of its administration has not been yet established therefore, we decided to compare the efficacy of drip infusion versus bolus administration of sodium bicarbonate in the treatment of TCAs poisoning.
Method: In this randomized clinical trial, 80 patients who had TCAs poisoning and, had been admitted to ICU were selected and divided into two groups. Both groups received 2 meq/kg of sodium bicarbonate in one bolus dose then group 1 received drip infusion of 2 litters of sodium bicarbonate (1.4% solution) additionally for the first 24 hours until the resolution of ECG and ABGs abnormalities. Patients' outcomes in the two groups were compared.
Results: More patients, after 8 hours, attaiened conscious in the drip infusion group. (p =0.012) and also this group reached significantly more normal ECG findings at 16 and 24 hours. (p = 0.013 and 0.005) There was no significant difference in ABGs outcomes between the two methods of administration.
Conclusion: Although our results support the beneficial effects of adding bolus sodium bicarbonate on consciousness and electrocardiographic abnormalities in TCAs poisoning patients, to identify more effective ways of sodium bicarbonate administration, further trials are warranted.
