ACUTE POISONING WITH
TRICYCLIC ANTIDEPRESSANTS (TcA) IN GREEK CHILDREN
Vadala H,
Sofidiotou V, Tzola E, Fountas K, Tsamadou A, Valti E
Poison Information Centre, Children’s
Hospital “P & A Kyriakou”, Athens, Greece
Objective: The study of TcA intoxication in Greek
children.
Methods: During the period 1998-2000 Greek Poison
Information Centre (GPCI) recorded 83 children (36 boys, 47 girls) poisoned
with TcA and their epidemiological and clinical data.
Results: The mean age was 4.19 years (6 months-15
years). 62.3% of the calls came from Health Care Facilities and 36.7% from
their family environment. Most cases occurred by accident, whereas 4 of
them were attempted suicides. Minitran (Amitriptylline + Perfenazine)
accounted for the majority of cases. while 11 patients had taken more than
one drug. The toxic manifestations recorded were: mydriasis, restlessness,
excitation, dizziness, unsteadiness, drowsiness, confusion, lethargy, coma,
tachycardia, cardiovascular collapsus, SIADH. 3 children were in coma and
their TcA plasma concentration ranged from 508.3 ng/ml to 719.5 ng/ml. The
duration of hospitalization varied between 1-9 days. In the majority of the
patients the outcome was good due to the small quantity of TcA ingested and
the prompt medical care, but some of them developed serious complications
and one of the comatose children died.
Conclusion: Because of the serious complications
related to TcA poisoning and the extended use of these drugs adults must be
informed about their toxicity and take precautions so that children do not
have ease access to TcA.