Amitriptyline cream ingestion in a 1-year-old boy

A 1-year-old boy presented to the emergency department with drowsiness after intoxication from amitriptyline cream. The amitriptyline level in his blood was in the high-therapeutic range for adults. He was admitted for cardiac monitoring. Except for a short episode with irregular heart rate, he reco...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2012-10, Vol.130 (4), p.e1030-e1033
Main Authors: Lak, Nathalie S M, Malingre, Mirte M, Hogeman, Paul H G
Format: Article
Language:English
Subjects:
Amitriptyline
Amitriptyline - poisoning
Antidepressants
Antidepressive Agents, Tricyclic - poisoning
Arrhythmia
Arrhythmias, Cardiac - chemically induced
Arrhythmias, Cardiac - diagnosis
Cardiac arrhythmia
Care and treatment
Children & youth
Complications and side effects
Diagnosis
Drunkenness
Drunkenness (Criminal law)
Emergency medical care
Humans
Infant
Intoxication
Male
Pediatrics
Poisoning - complications
Poisoning - diagnosis
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Summary:A 1-year-old boy presented to the emergency department with drowsiness after intoxication from amitriptyline cream. The amitriptyline level in his blood was in the high-therapeutic range for adults. He was admitted for cardiac monitoring. Except for a short episode with irregular heart rate, he recovered completely within 24 hours without adjuvant treatment. Amitriptyline is known as an antidepressant but is also prescribed for neuropathic pain. It is usually prescribed in tablet form; the cream is a novel application. In children, intoxication with amitriptyline may cause drowsiness, seizures, coma, hypotension, tachycardia, and life-threatening cardiac arrhythmias. This is the first case report presenting intoxication in a child with amitriptyline cream. It stresses the importance of keeping children away from the medicine cabinet, even from creams or ointments.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2011-3731