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Tri cyclic anti depressants as a cause of unexpected death


, : Tri cyclic anti depressants as a cause of unexpected death. Zeitschrift fuer Rechtsmedizin 84(4): 255-262

This study questions the anti-depressant efficacy of tricyclic antidepressant drugs (TAD) and emphasizes their cardiotoxicity. The number of lethal poisoning cases from the Swiss federal statistics on the cause of death amounted to 54 from 1967-1976. Ten of these 54 cases occurred in children who had ingested the drug accidentally; the remaining cases were adults who took an overdose of the drug intentionally. Forensic medical examinations were reviewed for 11 cases of unexpected death due to lethal poisoning with TAD. Data indicated that fatality can follow drug intake quite rapidly. Autoptical and histological findings were not specific. To confirm a poisoning diagnosis, levels of TAD and their metabolites were determined in 9 cases in various organ tissues and body fluids. Poisoning was due to imipramine (3 cases), opipramol (2 cases), dibenzepine (3 cases) and amitriptyline (3 cases).

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