Diagnostic pitfalls associated with amoxapine overdose: a case report. 1990

M V Miles, and R S Greenwood, and B Hussey
Division of Pharmacy Practice, School of Pharmacy, University of North Carolina, Chapel Hill 27599.

Amoxapine is a second-generation antidepressant that has been reported to cause seizures, severe acidosis, cardiac dysrhythmias, hypotension, renal failure, coma, and cardiorespiratory arrest in poisoning exposures. This is a report of a previously normal 9-year-old child who presented with generalized tonic clonic seizures that led to an extensive workup for primary generalized epilepsy. Nothing in the patient's history or laboratory test results suggested ingestion of a toxin. It was not until 48 hours after admission, when the child admitted taking several of her mother's amoxapine tablets, that the correct diagnosis was made. Because of the risks and the diagnostic pitfalls associated with ingestion of amoxapine, clinicians should be mindful of the lessons taught by this case.

UI MeSH Term Description Entries
D010634 Phenobarbital A barbituric acid derivative that acts as a nonselective central nervous system depressant. It potentiates GAMMA-AMINOBUTYRIC ACID action on GABA-A RECEPTORS, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. Phenemal,Phenobarbitone,Phenylbarbital,Gardenal,Hysteps,Luminal,Phenobarbital Sodium,Phenobarbital, Monosodium Salt,Phenylethylbarbituric Acid,Acid, Phenylethylbarbituric,Monosodium Salt Phenobarbital,Sodium, Phenobarbital
D010672 Phenytoin An anticonvulsant that is used to treat a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. Diphenylhydantoin,Fenitoin,Phenhydan,5,5-Diphenylhydantoin,5,5-diphenylimidazolidine-2,4-dione,Antisacer,Difenin,Dihydan,Dilantin,Epamin,Epanutin,Hydantol,Phenytoin Sodium,Sodium Diphenylhydantoinate,Diphenylhydantoinate, Sodium
D011041 Poisoning A condition or physical state produced by the ingestion, injection, inhalation of or exposure to a deleterious agent. Poisonings
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003989 Dibenzoxazepines
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000657 Amoxapine The N-demethylated derivative of the antipsychotic agent LOXAPINE that works by blocking the reuptake of norepinephrine, serotonin, or both; it also blocks dopamine receptors. Amoxapine is used for the treatment of depression. 2-Chloro-11-(1-piperazinyl)dibenz(b,f)(1,4)oxazepine,Asendin,Asendis,CL-67,772,Demolox,Desmethylloxapine,Défanyl,CL 67,772,CL67,772

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