Imipramine overdose

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Alternative names
Tofranil; Janimine

Definition
Poisoning from an overdose of imipramine (an antidepressant).

Poisonous Ingredient

• imipramine

Where Found

• Tofranil
  
• Berkomine
  
• Janimine
  
• Norpramin

Note: This list may not be all inclusive.

Symptoms

• body as a whole
  o dry mouth
  o urinary hesitancy
  o muscle rigidity
  o Convulsions
  o shock
  o incoordination
  o convulsions
  
• respiratory
  o breathing slowed and labored
  o pulmonary edema
  
• eyes, ears, nose, and throat
  o blurred vision
  o dilated pupils
  
• gastrointestinal
  o vomiting
  o constipation
  
• heart and blood vessels
  o irregular heartbeat
  o low blood pressure
  
• nervous system
  o drowsiness
  o Headache
  o dizziness
  o stupor
  o coma
  o agitation
  o restlessness

Home Treatment
Call the Poison Control center for guidance. DO NOT INDUCE EMESIS (VOMITING) UNLESS TOLD TO DO SO BY Poison Control.

Before Calling Emergency
Determine the following information:

• the patient’s age, weight, and condition
  
• the name of the product (ingredients and strengths if known)
  
• the time it was swallowed
  
• the amount swallowed
  
• if the medication was prescribed for the patient

Poison Control, or a local emergency number
They will instruct you if it is necessary to take the person to the hospital. See Poison Control centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room
Some or all of the following procedures may be performed:

• Induce emesis.
  
• Administer activated charcoal.
  
• Administer a laxative.
  
• Use gastric lavage.
  
• Monitor the patient’s vital signs (temperature, pulse, rate of breathing, Blood pressure).
  
• Maintain the patient’s airway.
  
• Replace fluid if appropriate.
  
• Monitor imipramine levels.
  
• Treat the symptoms.

Expectations (prognosis)
The amount swallowed and the time before appropriate therapy is initiated usually determine final outcome. Patients have died as late as 72 hours after an overdose ingestion. The sooner therapy is applied, the greater chance of a positive outcome.

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