Effect of amitriptyline antidotes on repetitive extrasystole threshold
Key result
Amitriptyline significantly lowered the repetitive extrasystole threshold from 28.8 to 8.2 mamp (p<0.001), an effect reversed by physostigmine, propranolol, sodium bicarbonate, and ganglionectomy.
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Discussion
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Implication
Suggests proarrhythmic effects in models; leaves open translation to clinical tricyclic toxicity or antidote strategies.
PICO
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Population
18 dogs evaluated for the effect of amitriptyline and its antidotes on repetitive extrasystole threshold.
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Intervention / Comparator
Amitriptyline vs Baseline (before amitriptyline)
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Primary Outcome
Repetitive extrasystole threshold (RET), p=<0.001
Main Result
Absolute Event Rate: 8.2% vs 28.8%
p-value: p=<0.001
Cite This Study
Tobis et al. (1980) studied Amitriptyline overdose and ventricular tachycardia (n=18). Amitriptyline vs. Baseline (before amitriptyline) was evaluated on Repetitive extrasystole threshold (RET) (p=<0.001). Amitriptyline significantly lowered the repetitive extrasystole threshold from 28.8 to 8.2 mamp (p<0.001), an effect reversed by physostigmine, propranolol, sodium bicarbonate, and ganglionectomy.