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KMID : 0377819910110070794
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Diagnosis and Treatment
1991 Volume.11 No. 7 p.794 ~ p.798
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CENTRAL NERVOUS SYTEM TOXICITY OF TRICYCLIC ANTIDEPRESSANTS
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임태식/Kim, Tae Shik
김광수/유태열/Kim, Kwang Soo/Lew Tae Yul
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Abstract
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Tricyclic antidepressants (TCAs) commonly produce side effects. even at subtherapeutic doses. The side effects include orthostatic hypotension, antichoiinergic(antimuscarinic) effects, quinidine like cardiac effects and central nervous system(CNS) toxicity. All of these side effects are doserelated, with lower doses producing toxicity in elderly patients. CNS toxicity of TCAs is serious, costly, frequent and difficult to diagnose early in its course. The incidence and severity of CNS toxicity are increased by concomitant administration of neuroleptic drugs. These untoward effects include mild dizziness and lightheadedness, insomnia, restlessness, or fatigue and somnolence, Confusion and delirium are not infriquent complications with TCAs, they may or may not be accompanied by signs suggesting anticholinergic intoxication.
The risk of this toxicity is positively correlated with TCA plasma levels, age and female gen-der. A proteean prodrome involving affective, psychotic, and cognitive symptoms preceded the delirium.
We have recently experienced two cases of CNS toxicity of TCAs, and reported these with the review of literatures.
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KEYWORD
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