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Treatment of Antidepressant Poisoning with Resin Hemoperfusion

Department of Anaesthesiology and Intensive Care and the Department of Nephrology, Sahlgren's Hospital and Psychiatric Department III, Lillhagen's Hospital, University of Gothenburg, Gothenburg, Sweden

Ingemar Wickström

Department of Anaesthesiology and Intensive Care and the Department of Nephrology, Sahlgren's Hospital and Psychiatric Department III, Lillhagen's Hospital, University of Gothenburg, Gothenburg, Sweden

Erik MÅrtensson

Department of Anaesthesiology and Intensive Care and the Department of Nephrology, Sahlgren's Hospital and Psychiatric Department III, Lillhagen's Hospital, University of Gothenburg, Gothenburg, Sweden

Jarl Ahlmén

Department of Anaesthesiology and Intensive Care and the Department of Nephrology, Sahlgren's Hospital and Psychiatric Department III, Lillhagen's Hospital, University of Gothenburg, Gothenburg, Sweden

1 The object of this study was to evaluate hemoperfusion in tricyclic antidepressant (TCA) poisoning.

2 Eight patients with severe TCA-poisoning and one patient with maprotiline poisoning were treated with resin hemoperfusion (HP). All patients were in Grade III or Grade IV coma with a QRS interval of 100 ms or greater. Hemoperfusion was started and continued until a satisfactory clinical response was obtained or for up to a maximum of 4 h.

3 Clearance values and extraction ratios were calculated during HP. The extraction ratio for all drugs was high (0.91-0.98) showing an effective clearance of these drugs from the blood compartment. After termination of HP a rebound effect of blood concentrations was seen in five cases. The total amount of the drug recovered was in no case greater than 3.1% of the estimated amount ingested.

4 It is therefore difficult to ascribe the clinical improvement seen in these patients during HP to the removal of significant amounts of the drug taken.

Human & Experimental Toxicology, Vol. 1, No. 4, 361-371 (1982)
DOI: 10.1177/096032718200100401


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