Læknablaðið - 15.03.1984, Blaðsíða 35
LÆKNABLADID
103
amitriptyline plus nortriptyline were on an average
higher in cases of poisoning with ámitriptyline alone
than with amitriptyline and other drugs (cf. tables II
& III). The differences were on all occasions statisti-
cally significant (P<0.05). Other non-antidepressant
drugs that were considered to contribute to death
were carisoprodol, chlordiazepoxide, clozapine, dia-
zepam, ethanol (10 cases), meprobamat, pentobarbi-
tal, promethazine, salicylic acid and trifluoperazine.
Organ levels in cases of poisoning with other
antidepressant drugs (table IV) were found compar-
able to those in cases of amitriptyline poisonings
(tables II & III). The resltlts indicated that the inci-
dence of death due to antidepressant drugs in Iceland
was relatively high in the period under observation.
Interestingly, there appeared to be concurrent
increase in death rates and sales of antidepressant
drugs during the years 1978 and 1979 (figs. 2 & 3).
The results furthermore indicated that although
many of the cases must be due to intake of excessive
amounts of the drugs, death might also occur due to
intake of antidepressant drugs in therapeutic doses
together with relatively small amounts of ethanol or
possibly other drugs.
HEIMILDIR
1) Kuhn R. The treatment of depressive states
with G22355 (imipramine hydrochloride). Am J
Psychiatry 1958; 115: 459-64.
2) Stephensen Ó. Eitrun af völdum tricycliskra
geðdeyfðarlyfja. Einkenni og meðferð. Lækna-
blaðið 1977;63:245-8.
3) Kristinsson J, Jóhannesson P, Bjarnason Ó,
Geirsson G. Organ levels of amitriptyline and
nortriptyline in fatal amitriptyline poisoning.
Acta Pharmacol Toxicol 1983; 52; 150-2.
4) Kæmpe B. Determination of an unknown drug
in forensic chemistry. I. Mutual interference of
drugs. Dansk Tidsskr Farm 1971; 45: 1-23.
5) Kristinsson J. A gas chromatographic method
for the determination of antidepressant drugs in
human serum. Acta Pharmacol Toxicol 1981;
49: 390-8.
6) Kristinsson J. An efficient method for the
extraction of antidepressant drugs from post
mortem samples. Acta Pharmacol Toxicol 1982;
50:318-20.
7) Rannsóknastofa í Iyfjafræði. Ársskýrslur 1977,
1978, 1979, 1980, 1981.
8) Kristinsson J. Um réttarefnafræði. Lækna-
neminn 1982; 35 (3-4); 10-15.
9) Teige B, Fleischer E. Medikament- og alkohol-
dodsfall undersokt ved Rettsmedisinsk institutt,
Universitetet i Oslo, i árene 1977-1979. Tidsskr
Nor Lægeforen 1981; 101: 1563-6.
10) Teige B. Persónulegar upplýsingar.
11) Nordiska lákemedelsnamden. Nordisk lakeme-
delsstatistik 1978-1980. Uppsala 1982; Del 1:
157-67.
12) Bailey BN, Shaw RF. Tricyclic antidepressants:
Interpretation of blood and tissue levels in fatal
overdose. J Anal Tox 1979; 3: 43-6.
13) Robinson A., McDowalI RD, Sattar H, Holder
AT, Powell R. Tricyclic and tetracyclic antide-
pressant drugs; Forensic toxicology of some
autopsy cases. J Anal Tox 1979; 3; 3-13.
14) Hebb JH, Caplan UH, Crooks CR, Mergner WJ.
Blood an tissue concentrations of tricyclic
antidepressant drugs in post mortem cases:
Literature survey and a study of fourty deaths. J
AnalTox 1982;6:209-16.
15) Baselt RC. Amitriptyline. In: Disposition of
toxic drugs and chemicals in man. Connecticut;
Biomedical Publications, 1978; vol 1: 170-4.
16) King LA. Synergistic effect of benzodiazepines
in fatal amitriptyline poisonings. Lancet 1982; 2
(8305); 982-3.
17) Lingjærde O. Psykofarmaka (2. útg.) Osló:
Tanum-Norli, 1976; 223-94.