Hagerman G A, Hanashiro P K
Ann Emerg Med. 1981 Feb;10(2):82-6. doi: 10.1016/s0196-0644(81)80342-3.
Ten patients with cardiac conduction defects due to severe tricyclic antidepressant poisoning were successfully treated with intravenous phenytoin. Eight patients had combined first degree AV block and intraventricular conduction delay; one patient had first degree AV block alone; and one patient had intraventricular conduction delay alone. Phenytoin was injected at a rate of 50 mg/min in amounts not exceeding 500 mg (approximately 5 mg/kg to 7 mg/kg). Five patients had complete normalization within 46 min. The remaining five patients showed improvement in their conduction defects shortly after phenytoin treatment, with complete normalization occurring within 14 hr. This investigation demonstrated the effectiveness of phenytoin in reversing tricyclic-antidepressant-induced cardiac conduction abnormalities. Phenytoin is a logical drug for the treatment of severe tricyclic antidepressant poisoning signalled by first degree AV block and/or intraventricular conduction delay.
10例因严重三环类抗抑郁药中毒导致心脏传导缺陷的患者经静脉注射苯妥英钠成功治愈。8例患者合并一度房室传导阻滞和室内传导延迟；1例患者仅有一度房室传导阻滞；1例患者仅有室内传导延迟。以50mg/min的速度静脉注射苯妥英钠，剂量不超过500mg（约5mg/kg至7mg/kg）。5例患者在46分钟内完全恢复正常。其余5例患者在苯妥英钠治疗后不久传导缺陷有所改善，14小时内完全恢复正常。本研究证明了苯妥英钠在逆转三环类抗抑郁药引起的心脏传导异常方面的有效性。苯妥英钠是治疗由一度房室传导阻滞和/或室内传导延迟所提示的严重三环类抗抑郁药中毒的合理用药。
