Özet:
Objective: High-dose amitriptyline is a common cause of childhood poisoning. The aim of this study was to evaluate the demographic and clinical characteristics of 126 children who presented with amitriptyline poisoning.
Material and Methods: The medical records of children who were admitted to the Pediatric Intensive Care Unit for amitriptyline poisoning between January 1986 and March 2011 were retrospectively evaluated.
Results: High-dose amitriptyline is a common cause of childhood poisoning. An increase in the number of cases of amitriptyline poisoning was observed in recent years, with 62.7% of all cases being accidental whereas 37.3% of cases were attempted suicides. The mean age of accidental cases of poisoning was 2.9±1.4 years compared to 14.2±1.9 years for suicidal cases (p<0.01). Patients who accidentally ingested amitriptyline presented to a health care facility in a shorter period than those who took the drug with suicidal intent (respectively 2.4±2 hours vs. 4.2±4.3 hours; p<0.01). In 78.3% of cases, the drug was stored in place easily accessible to children. While 37.3% of patients took the drug at toxic doses, in 47.6% of patients the amount of amitriptyline ingested was below the toxic dose. Seventy-one percent of patients had neurological symptoms on presentation. Gastric lavage was the most commonly utilized treatment modality (78% all of cases). Only one patient who had accidentally consumed the drug at a dose of 15mg/kg died.
Conclusion: There is a dire need for reforms in political, industrial and public health policies regarding the packaging and storage of medications which are a common cause of accidental drug poisoning with potentially severe consequences.
