How are seizures treated in pediatric patients with tricyclic antidepressant (TCA) toxicity?

Updated: Mar 18, 2020
  • Author: Derrick Lung, MD, MPH; Chief Editor: Stephen L Thornton, MD  more...
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Answer

Seizures secondary to cyclic antidepressant toxicity are generally self-limiting but should be treated because the acidosis produced by vigorous muscle contraction and impaired ventilation during seizure activity may increase the concentration of free drug and increase toxicity. Benzodiazepines are the agents of choice. Phenobarbital may be used as a long-acting anticonvulsant.  Intravenous sodium bicarbonate therapy may be considered as an adjunct to benzodiazepine or barbiturates. Phenytoin should be avoided owing to possible interaction. [9]  


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