Key result
Sodium bicarbonate was the most effective treatment for cardiac arrhythmias complicating tricyclic antidepressant overdosage, with physostigmine serving as a useful second-line option.
Why the study?
Which antiarrhythmic treatments are most effective for cardiac arrhythmias complicating tricyclic antidepressant overdosage?
Which antiarrhythmic treatments are most effective for cardiac arrhythmias complicating tricyclic antidepressant overdosage?
Sodium bicarbonate is the most effective treatment for cardiac arrhythmias resulting from tricyclic antidepressant overdose.
May support sodium bicarbonate as initial therapy for TCA-induced arrhythmias; leaves open need for randomized trials to confirm.
Tricyclic antidepressant overdosage may be complicated by cardiac arrhythmias, which were sometimes difficult to treat prior to the use of sodium bicarbonate. Experiments have been done with several antiarrhythmics in an attempt to define the optimum treatment. Sodium bicarbonate proved the most effective experimentally and this supports our clinical experience. Physostigmine is a useful second drug, having beneficial effects against arrhythmias and central nervous system manifestations of toxicity. Practolol, although reversing the arrhythmias, tends to cause hypotension. Other drugs tried were less effective.
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T. C. K. Brown (1976) conducted a review in Tricyclic antidepressant overdosage with cardiac arrhythmias. Sodium bicarbonate vs. Other antiarrhythmics (e.g., physostigmine, practolol) was evaluated on Reversal of cardiac arrhythmias. Sodium bicarbonate was the most effective treatment for cardiac arrhythmias complicating tricyclic antidepressant overdosage, with physostigmine serving as a useful second-line option.
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