Tricyclic antidepressants intoxication in Tehran, Iran: Epidemiology and associated factors

Abstract

Background: Tricyclic antidepressant (TCA) intoxication contributes a large number of drug toxicities with serious complications. There are a few studies about factors associated with TCA intoxication. This study therefore aimed to identify determinants of this type of intoxication. Methods: A cross-sectional study was carried out at Loghman-Hakim Poison Hospital during a 6-month period. All poisoned patients aged >12 years presented to this hospital during the mentioned period were evaluated. Then, TCA-poisoned patients were compared with other drug intoxications as the control group to determine factors associated with TCA intoxications. Results: There were 9809 admissions, of which 1583 (16.1%) patients including 601 (38%) males were intoxicated with TCAs. Mean age of the subjects was 26.5 + 10 years. Most of the TCA intoxications (74.4%) were intentional (p = 0.01). Amitriptyline was the most frequent agent followed by Nortriptyline. There was no significant difference between TCA and non-TCA intoxications regarding the mortality (1.3% in TCA vs. 1.1% in others, p = 0.45). Logistic regression analysis revealed that sex, addiction status, and history of psychological problems have association with TCA intoxication. Conclusions: The results of this study are helpful in identifying individuals who are prone to TCA intoxication and may be useful in implementation of preventive strategies.