Maprotiline drug overdose

Placebo-controHed studies In a doubleblind, randomized, placebo-controlled study in 105 unconscious adults with suspected drug overdose, 73 of whom had taken benzodiazepines, flumazenil caused adverse effects in nine cases agitation (n = 3), a depressive mood (n = 3), nausea and vomiting (n = 1), shivering (n = 1), and one severe adverse reaction—a sudden fall in blood pressure in a 28-year-old woman in deep coma after combined poisoning with benzodiazepines and maprotiline [95 "]. 

Although its mechanism of action is similar to that of desipramine and maprotiline, reboxetine is not a TCA, and, in contrast, does not inhibit electrically excitable membranes. For this reason, overdose of reboxetine should not carry a significant risk of cardiotoxicity or seizures. Although a distinct advantage, the aforementioned is based on preclinical data because there is minimal clinical experience with overdoses of this drug. 

Overdoses of amoxapine are characterized by severe neurotoxicity, with seizures that are difficult to control. Overdoses of maprotiline also have a tendency to cause seizures as well as cardiotoxicity. Overdoses of the other heterocyclic drugs appear to create only minor problems and can usually be managed with purely supportive measures. For example, in one recorded case even 11 g of nefazodone failed to cause serious injury. 

Lew authors described antidepressant analysis in alternative specimens, such as hair or oral fluid. LC-CID-MS and MS/MS mass spectra libraries for identification of several drugs were employed by Muller et al. [32] for the detection of maprotiline, citalopram, and their desmethyl metabolites in authentic hair specimens extracted ions chromatograms were employed for subsequent antidepressant quantification. Also Klys et al. [33] applied LC-MS/MS to the analysis of blood, urine, and hair specimens in a fatal case due to clomipramine overdose in combination with alcohol. Blood clomipramine and norclomipramine concentrations explained the fatal outcome, and hair analysis confirmed that the deceased was on clomipramine treatment for, at least, 12 months prior to his death. With regard to oral fluid analysis, de Castro et al. [34] developed and validated a... 

Reports of overdose with maprotiline relate to doses of 750-3200 mg (21,22). The symptoms included impaired consciousness, convulsions, confusion, disorientation, visual hallucinations, and electrocardiographic changes similar to those seen with tricyclic compounds. Among 41 patients who had taken overdoses of maprotiline car-diotoxicity was equal to or greater than that of tricyclic drugs (23). Mania occurred in one case of maprotiline overdose (SEDA-17, 22). 

Seizures Because the convulsive threshold is lowered by tricyclic drugs and by MAO inhibitors, seizures may occur with overdoses of these agents. Overdoses of maprotiline and the SSRls have also caused seizures. 

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