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The British National Formulary notes that amitriptyline can be particularly dangerous in overdose, [70] thus it and other TCAs are no longer recommended as first-line therapy for depression. The treatment of overdose is mostly supportive as no specific antidote for amitriptyline overdose is available.
The peripheral autonomic nervous system, central nervous system and the heart are the main systems that are affected following overdose. [1] Initial or mild symptoms typically develop within 2 hours and include tachycardia, drowsiness, a dry mouth, nausea and vomiting, urinary retention, confusion, agitation, and headache. [7]
The side effects of the TCAs usually come to prominence before the therapeutic benefits against depression and/or anxiety do, and for this reason, they may potentially be somewhat dangerous, as volition can be increased, possibly giving the patient a greater desire to attempt or commit suicide.
Elavil (amitriptyline) – a tricyclic antidepressant used as a first-line treatment for neuropathic pain; Eurodin, Prosom – a benzodiazepine derivative with anxiolytic, anticonvulsant, hypnotic, sedative and skeletal muscle relaxant properties, commonly prescribed for short-term treatment of insomnia
Drugs or medicines may be withdrawn from commercial markets because of risks to patients, but also because of commercial reasons (e.g. lack of demand and relatively high production costs).
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