Amitriptyline hydrochloride overdose
Amitriptyline hydrochloride is a type of prescription medicine called a tricyclic antidepressant. Amitriptyline hydrochloride overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
Elavil overdose; Adepril overdose; Endep overdose; Enovil overdose; Trepiline overdose
Amitriptyline hydrochloride is a prescription medication. Brands include:
Note: This list may not be all-inclusive.
Airways and lungs:
Bladder and kidneys:
- Inability to urinate
- Urinary hesitancy
Eyes, ears, nose, and throat:
- Blurred vision
- Dry mouth
- Enlarged pupils
Heart and blood:
- Low blood pressure
- Irregular heart rate
- Coma (sudden onset)
- Convulsions (sudden onset)
- Inability to concentrate
- Lack of alertness (stupor)
- Muscle rigidity
- Uncoordinated movement
Stomach and intestines:
- Increased appetite
- Weight gain
This can be a very serious overdose. Seek immediate medical help.
Before Calling Emergency
Determine the following information:
- Patient's age, weight, and condition
- Name of the product (ingredients and strengths, if known)
- Time it was swallowed
- Amount swallowed
- If the medication was prescribed for the patient
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.
The patient may receive:
- Activated charcoal
- Breathing support, including a tube through the mouth and breathing machine (ventilator)
- Chest x-ray
- EKG (heart tracing)
- Fluids through a vein (by IV)
- Medicine called an antidote (sodium bicarbonate) to reverse the effects of the poison
- Tube through the mouth into the stomach to empty the stomach (gastric lavage)
Amitriptyline hydrochloride can be an extremely serious overdose.
Patients who swallow an excessive amount of this drug are almost always admitted to the hospital.
How well a patient does depends on how much of the drug was swallowed and how quickly treatment was received. The faster a patient gets medical help, the better the chance of recovery. Complications such as pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. Death can occur.
Woolf AD, Erdman AR, Nelson LS, et al. American Association of Poison Control Centers. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol. 2007;45(3):203-233.
Kirk MA, Baer AB. Anticholinergics and antihistamines. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 39.
Velez LI, Feng S-Y. Anticholinergics. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 150.
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.