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Clinical Toxicology Volume 4, 1971 - Issue 3
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Research Article

Physostigmine Therapy in Acute Tricyclic Antidepressant Poisoning

Thomas L. Slovis Physician's Poison Consultation Service University of Colorado Medical Center; University of Arizona College of Medicine
,
John E. Ott Physician's Poison Consultation Service University of Colorado Medical Center; Children's Hospital of Denver, Denver, Colorado
,
Daniel T. Teitelbaum Physician's Poison Consultation Service University of Colorado Medical Center; Children's Hospital of Denver, Denver, Colorado
&
William Lipscomb Physician's Poison Consultation Service University of Colorado Medical Center; Children's Hospital of Denver, Denver, Colorado
Pages 451-459 | Published online: 25 Sep 2008

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George Sam Wang, Keith Baker, Patrick Ng, Gregory C. Janis, Jan Leonard, Rakesh D. Mistry & Kennon Heard. (2021) A randomized trial comparing physostigmine vs lorazepam for treatment of antimuscarinic (anticholinergic) toxidrome. Clinical Toxicology 59:8, pages 698-704.
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. (2003) What To Do with Case Reports: Is Folly That Succeeds Folly Nonetheless?. Journal of Toxicology: Clinical Toxicology 41:4, pages 377-379.
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Antoine El-Hage, Tibor Balazs & William L. West. (1982) Protective Effects of Clonidine and Verapamil in Experimental Amitriptyline Poisoning in Rabbits. Journal of Toxicology: Clinical Toxicology 19:3, pages 321-335.
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Paul R. Pentel, Milton L. Bullock & C. Lindsay DeVane. (1982) Hemoperfusion for Imipramine Overdose: Elimination of Active Metabolites. Journal of Toxicology: Clinical Toxicology 19:3, pages 239-248.
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Ary L. Goldberger & Guy P. Curtis. (1982) Immediate Effects of Physostigmine on Amitriptyline-Induced QRS Prolongation. Journal of Toxicology: Clinical Toxicology 19:5, pages 445-454.
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Bert K. B. Lum, Christopher H. Follmer, Raymond H. Lockwood & Harry M. Thomas. (1982) Experimental Studies on the Effects of Physostigmine and of Isoproterenol on Toxicity Produced by Tricyclic Antidepressant Agents. Journal of Toxicology: Clinical Toxicology 19:1, pages 51-65.
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Anthony S. Manoguerra & Robert W. Steiner. (1981) Prolonged Neuromuscular Blockade after Administration of Physostigmine and Succinylcholine. Clinical Toxicology 18:7, pages 803-805.
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William K. Summers, Kenneth R. Kaufman, Frank Altman & John M. Fischer. (1980) THA—A Review of the Literature and Its Use in Treatment of Five Overdose Patients. Clinical Toxicology 16:3, pages 269-281.
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Richard C. W. Hall, Janice Fox, SondraK. Stickney, EarlR. Gardner & Mark Perl. (1978) Anticholinergic Delirium: Etiology, Presentation, Diagnosis and Management. Journal of Psychedelic Drugs 10:3, pages 237-241.
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P. DOLARA & F. FRANCONI. (1977) Hypertonic Sodium Chloride and Lidocaine in a Case of Imipramine Intoxication. Clinical Toxicology 10:4, pages 395-398.
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M. A. Vance, S. M. Ross, W. R. Millington & J. B. Blumberg. (1977) Potentiation of Tricyclic Antidepressant Toxicity by Physostigmine in Mice. Clinical Toxicology 11:4, pages 413-421.
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Anthony S. Manoguerra & Lawrence C. Weaver. (1977) Poisoning with Tricyclic Antidepressant Drugs. Clinical Toxicology 10:2, pages 149-158.
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Joel R. Saper. (1976) Secondary metabolic encephalopathy. Postgraduate Medicine 59:5, pages 122-128.
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T. C. K. Brown. (1976) Tricyclic Antidepressant Overdosage. Clinical Toxicology 9:2, pages 255-272.
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Barry H. Rumack, Robert J. Anderson, Robert Wolfe, Eugene C. Fletcher & Bonita K. Vestal. (1974) Ornade and Anticholinergic Toxicity: Hypertension, Hallucinations, and Arrhythmias. Clinical Toxicology 7:6, pages 573-581.
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Articles from other publishers (63)

Michael E. Mullins. (2021) Physostigmine should be used more readily for antimuscarinic toxicity: CON. British Journal of Clinical Pharmacology 88:1, pages 61-63.
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Sharon L. Crowell‐Davis, Thomas F. Murray & Leticia Mattos DantasSharon L. Crowell‐Davis. 2019. Veterinary Psychopharmacology. Veterinary Psychopharmacology 231 256 .
William J. Boroughf. 2017. Critical Care Toxicology. Critical Care Toxicology 2943 2955 .
Andrew H. Dawson & Nicholas A. Buckley. (2015) Pharmacological management of anticholinergic delirium ‐ theory, evidence and practice. British Journal of Clinical Pharmacology 81:3, pages 516-524.
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William J. Boroughf. 2016. Critical Care Toxicology. Critical Care Toxicology 1 14 .
Joseph W. Watkins, Evan S. Schwarz, Anna M. Arroyo-Plasencia & Michael E. Mullins. (2014) The Use of Physostigmine by Toxicologists in Anticholinergic Toxicity. Journal of Medical Toxicology 11:2, pages 179-184.
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D. ERIC BRUSH & CYNTHIA K. AARON. 2007. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose 537 548 .
Donna L Seger. (2006) A Critical Reconsideration of the Clinical Effects and Treatment Recommendations for Sodium Channel Blocking Drug Cardiotoxicity. Toxicological Reviews 25:4, pages 283-296.
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Sharon Crowell‐Davis & Thomas Murray. 2005. Veterinary Psychopharmacology. Veterinary Psychopharmacology 179 206 .
Nicole L. Ries & Richard C. Dart. (2005) New Developments in Antidotes. Medical Clinics of North America 89:6, pages 1379-1397.
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Jeffrey R Suchard. (2003) Assessing physostigmine’s contraindication in cyclic antidepressant ingestions. The Journal of Emergency Medicine 25:2, pages 185-191.
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David J. Triggle, John M. Mitchell & Ron Filler. (1998) The Pharmacology of Physostigmine. CNS Drug Reviews 4:2, pages 87-136.
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Joseph H. Flaherty. (1998) Commonly Prescribed and Over-The-Counter Medications: Causes of Confusion. Clinics in Geriatric Medicine 14:1, pages 101-128.
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Henry Cohen, Robert S. Hoffman & Mary Ann Howland. (2016) Antidepressant Poisoning and Treatment: A Review and Case Illustration. Journal of Pharmacy Practice 10:4, pages 249-270.
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K. Knudsen. 1996. Human Toxicology. Human Toxicology 301 317 .
Daniela Amital & R.H Belmaker. (1994) Lithium involvement in physostigmine-induced seizures. Biological Psychiatry 36:7, pages 498.
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Henry Cohen, Robert S. Hoffman & Mary Ann Howland. (2016) Cyclic Antidepressant Poisoning: A Review and Case Report. Journal of Pharmacy Practice 6:2, pages 89-102.
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Stephanie A. Miller, Dennis W. Blick, Sandra Z. Kerenyi & Michael R. Murphy. (1993) Efficacy of physostigmine as a pretreatment for organophosphate poisoning. Pharmacology Biochemistry and Behavior 44:2, pages 343-347.
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Lori K. Danze & Mark I. Lanqdorf. (1991) Reversal of orphenadrine-induced ventricular tachycardia with physostigmine. The Journal of Emergency Medicine 9:6, pages 453-457.
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Farid J. Muhtadi & Seham S. El-Hawary. 1990. 289 350 .
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Peter Crome. (2012) Poisoning Due to Tricyclic Antidepressant Overdosage. Medical Toxicology 1:4, pages 261-285.
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Wesley G. Clark & J.M. Lipton. (1986) Changes in body temperature after administration of adrenergic and serotonergic agents and related drugs including antidepressants: II. Neuroscience & Biobehavioral Reviews 10:2, pages 153-220.
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Michael Callaham. (1985) Epidemiology of fatal tricyclic antidepressant ingestion: implications for management. Annals of Emergency Medicine 14:1, pages 1-9.
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Toby L. Litovitz. (1984) The Anecdotal Antidotes. Emergency Medicine Clinics of North America 2:1, pages 145-158.
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Carlton K. Erickson. 1983. The Biology of Alcoholism. The Biology of Alcoholism 591 611 .
B. Van Sweden & M. Dumon-Radermecker. (1982) The EEG in Chronic Psychotropic Drug Intoxications. Clinical Electroencephalography 13:4, pages 206-215.
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John B. Marshall & Alan D. Forker. (1982) Cardiovascular effects of tricyclic antidepressant drugs: Therapeutic usage, overdose, and management of complications. American Heart Journal 103:3, pages 401-414.
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L. R. Hines. 1981. Psychotropic Agents. Psychotropic Agents 359 393 .
Richard C. W. Hall, Michael K. Popkin, Sondra K. Stickney & Earl R. Gardner. 1981. Drug Dependence and Alcoholism. Drug Dependence and Alcoholism 1129 1137 .
Paul Pentel & Charles D. Peterson. (1980) Asystole complicating physostigmine treatment of tricyclic antidepressant overdose. Annals of Emergency Medicine 9:11, pages 588-590.
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W.Marvin Davis & Nabil S. Hatoum. (1980) Synergism of the toxicity of physostigmine and neostigmine by lithium or by a reserpine-like agent (Ro4-1284). Toxicology 17:1, pages 1-7.
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P. Thomann & R. Hess. 1980. Psychotropic Agents. Psychotropic Agents 527 549 .
J. Roman Bastani. (1979) Physostigmine treatment of tricyclic overdosage in psychosis. Psychosomatics 20:12, pages 847-848.
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B. Sangster, A. Van Dijk & J. H. Glerum. (1979) Fysostigmine bij de behandeling van vergiftigingenPhysostigmine in the treatment of drug-intoxications. Pharmaceutisch weekblad 1:1, pages 345-350.
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Michael Callaham. (1979) Tricyclic antidepressant overdose. Journal of the American College of Emergency Physicians 8:10, pages 413-425.
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William K. SummersTheodore C. Reich. (1979) Delirium After Cataract Surgery: Review and Two Cases. American Journal of Psychiatry 136:4A, pages 386-391.
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Maurice W Dysken. (1978) Anticholinergic Psychosis. Psychiatric Annals 8:9, pages 30-42.
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William K. Summers. (1978) A clinical method of estimating risk of drug induced delirium. Life Sciences 22:17, pages 1511-1516.
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S.‐M. Aquilonius & U. Hedstrand. (2008) The Use of Physostigmine as an Antidote in Tricyclic Anti‐depressant Intoxication. Acta Anaesthesiologica Scandinavica 22:1, pages 40-45.
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S.-M. Aquilonius. 1978. Cholinergic Mechanisms and Psychopharmacology. Cholinergic Mechanisms and Psychopharmacology 817 825 .
Gary E. Hill, Theodore H. Stanley & Craig R. Sentker. (1977) Physostigmine reversal of postoperative somnolence. Canadian Anaesthetists’ Society Journal 24:6, pages 707-711.
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Moshe Rehavi, Saul Maayani & Mordechai Sokolovsky. (1977) Tricyclic antidepressants as antimuscarinic drugs: In vivo and in vitro studies. Biochemical Pharmacology 26:17, pages 1559-1567.
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Michael Sheehan & Patricia Haythorn. (1977) Combined thin-layer and gas-liquid chromatographic identification of tricyclic antidepressants in urine. Journal of Chromatography A 132:2, pages 237-247.
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Stephen P. Wright. (2016) Usefulness of Physostigmine in Imipramine Poisoning. Clinical Pediatrics 15:12, pages 1123-1128.
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R. S. HendersonC. McK. Holmes. (2019) Reversal of the Anaesthetic Action of Sodium Gamma-Hydroxybutyrate. Anaesthesia and Intensive Care 4:4, pages 351-354.
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William E. Walker, Richard C. Levy & Irwin B. Hanenson. (1976) Physostigmine — Its use and abuse. Journal of the American College of Emergency Physicians 5:6, pages 436-439.
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L. S. Chin, J. H. Havill, R. P. G. Rothwell & B. G. Bishop. (2019) Use of Physostigmine in Tricyclic Antidepressant Poisoning. Anaesthesia and Intensive Care 4:2, pages 138-140.
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Anthony S. Manoguerra & Ernest Ruiz. (1976) Physostigmine treatment of anticholinergic poisoning. Journal of the American College of Emergency Physicians 5:2, pages 125-127.
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Stephen N. Steen. (1976) The effects of psychotropic drugs on respiration. Pharmacology & Therapeutics. Part B: General and Systematic Pharmacology 2:4, pages 717-741.
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A. G. Rauws & M. Olling. (1976) Treatment of experimental imipramine and desipramine poisoning in the rat. Archives of Toxicology 35:2, pages 97-106.
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T.C.K. BROWN. (1975) Overdosage - The rise and fall of tricyclic antidepressanls. Journal of Paediatrics and Child Health 11:3, pages 190-194.
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Byron C. Jones, Paul F. Consroe & Faren Akins. (2013) Physostigmine-induced reversal of EEG and behavioral effects of ?9-tetrahydrocannabinol. Bulletin of the Psychonomic Society 6:2, pages 204-206.
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WILLIAM E. THORNTON & BONNIE J. PRAY. (2013) Combination Drug Therapy in Psychopharmacology. The Journal of Clinical Pharmacology 15:7, pages 511-517.
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Rodrigo A. Munoz & James B. Kuplic. (1975) Large Overdose of Tricydic Antidepressants Treated With Physostigmine Salicylate. Psychosomatics 16:2, pages 77-78.
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J. Buus Lassen, R. F. Squires, J. A. Christensen & L. Molander. (1975) Neurochemical and pharmacological studies on a new 5HT-uptake inhibitor, FG4963, with potential antidepressant properties. Psychopharmacologia 42:1, pages 21-26.
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T. C. K. Brown, F. I. Bishop & G. C. Mullins. (2019) Drug Overdosage in Children. Anaesthesia and Intensive Care 2:4, pages 303-309.
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Robert G. Pietrusko. (2016) Physostigmine in Amitriptyline Overdose. Drug Intelligence & Clinical Pharmacy 8:3, pages 144-144.
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John M Davis. (1973) OVERDOSE OF PSYCHOTROPIC DRUGS. Psychiatric Annals 3:6, pages 6-6.
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