Amitriptyline/diphenhydramine overdose
- PDF / 141,182 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 44 Downloads / 157 Views
1
OS
Delirium: case report A 48-year-old woman developed delirium after an overdose of amitriptyline and diphenhydramine [routes and dosages not stated]. She also took laxatives. The woman was admitted after her overdose and, on hospital day 3, psychiatric consultation was sought due to pressured speech and psychomotor agitation. On examination she was disoriented with vacillating alertness and cognition. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was positive for delirium. She began receiving olanzapine. Laboratory investigations revealed toxic amitriptyline and nortriptyline levels. She had an elevated heart rate and body temperature with dilated, sluggish pupils and hot, dry skin. Her delirium was considered to be an anticholinergic syndrome resulting from amitriptyline/diphenhydramine toxicity. Olanzapine was subsequently switched to ziprasidone. After 2 days she had improved and within 6 days her CAM-ICU result was negative for delirium, despite developing medical comorbidities. Spiegel DR, et al. Atypical antipsychotics for delirium: A reasonable alternative to 803053038 haloperidol? Current Psychiatry 10: 37-46, No. 1, Jan 2011 - USA
0114-9954/10/1347-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 16 Apr 2011 No. 1347
Data Loading...
