Tricyclic antidepressant overdose.

The following paper will discuss recent literature concerning TCA overdose and review cases seen over a one-year period at the Ottawa Civic Hospital. Discussion will centre around the issue of prolonged cardiac monitoring and the use of sodium bicarbonate in the treatment of dysrhythmias. The authors review 33 cases admitted over a one-year period to the Ottawa Civic Hospital with a diagnosis of tricyclic or tricyclic plus other drug ingestion. They discuss methods of treatment with particular emphasis on repeated charcoal dosing. The various cardiac arrhythmias are discussed briefly, as are the pharmacological characteristics of the tricyclics. The need for prolonged monitoring is reviewed, and specific recommendations are made about the duration of monitoring. The use of sodium bicarbonate intravenously as the drug of choice in the treatment of arrhythmias is discussed.