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Amitriptyline and perphenazine overdose

Definition

Amitriptyline and perphenazine is a combination drug that is sometimes prescribed for patients with depression, agitation, or anxiety.

Amitriptyline and perphenazine 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.

Alternative Names

Etrafon overdose; Triavil overdose; Triptazine overdose

Poisonous Ingredient

Amitriptyline and perphenazine

Where Found

Etrafon
PMS-Levazine
Triavil
Triptazine

Note: This list may not be all-inclusive.

Symptoms

Airways and lungs
- Breathing - slowed and labored
Bladder and kidneys
- Urinary hesitancy
- Inability to completely empty the bladder
Eyes, ears, nose, throat, and mouth
- Blurred vision
- Dry mouth
- Enlarged pupils
- Nasal congestion
- Unpleasant taste
Heart and blood
- Irregular heartbeat
- Heartbeat - rapid
- Low blood pressure (severe)
- Shock
Muscles and joints
Nervous system
- Agitation
- Coma
- Convulsions
- Disorientation
- Drowsiness
- Fever
- Hypothermia (body temperature is lower than normal)
- Restlessness
- Seizures
- Stupor (lack of alertness)
- Uncoordinated movement
- Tremor
- Weakness
Reproductive system
- Change in menstrual patterns
Skin
- Itchy skin
- Rash
Stomach and intestines
- Constipation
- Loss of appetite
- Nausea
- Vomiting

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

Poison Control, or a local emergency number

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.

See: Poison control center - emergency number

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
Medicine (sodium bicarbonate) to reverse the effects of the overdose
Breathing support, including a breathing tube
Fluids through a vein (by IV)
Laxative
Tube from the mouth into the stomach to empty the stomach (gastric lavage)

Expectations (prognosis)

This can be an extremely serious overdose. Death is possible. How well a patient does depends on how much of the drug was swallowed and how quickly medical treatment was received. The faster a patient receives medical help, the better the chance for recovery.

Survival past 2 weeks is usually a good sign.

References

Brush DE, Aaron CK. Tricyclic and other cyclic antidepressants. 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 27.

Disclaimers

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A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
Call 911 for all medical emergencies.
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