King Matthew, Ashraf Nauman
Ozark Center, Freeman Hospital, Kansas City University of Medicine and Biosciences, 2002 Hampshire Terrace apt 2, Joplin, MO, 64804, USA.
Department of Behavioral Sciences, OSU-COM, Columbus, OH, USA.
Drug Saf Case Rep. 2018 Jan 2;5(1):1. doi: 10.1007/s40800-017-0069-5.
The tricyclic antidepressants, while older, still have their place in the treatment of depression today. They are efficacious but less selective and thus have the potential of eliciting many side effects. Anticholinergic delirium is a potential complication when using a tricyclic antidepressant or other anticholinergic agent. Following the Naranjo algorithm, this case report describes a probable amitriptyline-induced delirium in a previously healthy, 36-year-old Caucasian male individual after he promptly resumed his nightly 200-mg amitriptyline dose, following abrupt discontinuation of the medication 1 week earlier. This case emphasizes the importance of drug titration/tapering and therapeutic drug monitoring of patients taking tricyclic antidepressants.
三环类抗抑郁药虽然问世已久,但在如今的抑郁症治疗中仍有一席之地。它们疗效显著,但选择性较差,因此有可能引发多种副作用。使用三环类抗抑郁药或其他抗胆碱能药物时,抗胆碱能谵妄是一种潜在的并发症。本病例报告依据纳朗霍算法,描述了一名此前健康的36岁白人男性,在1周前突然停用每晚200毫克阿米替林剂量后又迅速恢复用药后,可能由阿米替林诱发的谵妄。该病例强调了对服用三环类抗抑郁药的患者进行药物滴定/逐渐减量以及治疗药物监测的重要性。