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Læknablaðið - 15.03.1984, Síða 35

Læknablaðið - 15.03.1984, Síða 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.

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