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Amitriptyline and perphenazine overdose

Triptazine overdose

Amitriptyline and perphenazine is a combination medicine. It is sometimes prescribed for people with depression, agitation, or anxiety.

Amitriptyline and perphenazine overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has overdosed, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Amitriptyline and perphenazine can be very harmful in large amounts.

Where Found

Medicines with this brand name contain amitriptyline and perphenazine:

• Triptazine

Other medicines may also contain amitriptyline and perphenazine.

Symptoms

Below are symptoms of an amitriptyline and perphenazine overdose in different parts of the body. These symptoms may occur more often or be more severe in people who also take certain other medicines that affect serotonin, a chemical in the brain.

AIRWAYS AND LUNGS

• Slowed, labored breathing
• No breathing

BLADDER AND KIDNEYS

• Hard to start urinating, and urine stream may be weak
• Inability to completely empty the bladder

EYES, EARS, NOSE, THROAT, AND MOUTH

• Blurred vision
• Dry mouth
• Enlarged pupils
• Eye pain in people at risk for a type of glaucoma
• Nasal congestion
• Unpleasant taste in mouth

HEART AND BLOOD

• Irregular heartbeat
• Low blood pressure (severe)
• Rapid heartbeat
• Shock

MUSCLES AND JOINTS

• Muscles are rigid
• Muscle cramps, spasms, or stiffness of the limbs
• Stiff muscles in neck, face, or back

NERVOUS SYSTEM

• Agitation
• Coma (decreased level of consciousness and lack of responsiveness)
• Seizures
• Delirium
• Disorientation
• Drowsiness
• Lower than normal body temperature
• Restlessness
• Uncoordinated movement
• Tremor
• Weakness

REPRODUCTIVE SYSTEM

• Change in menstrual patterns

SKIN

• Itchy skin
• Rash

STOMACH AND INTESTINES

• Constipation
• Loss of appetite
• Nausea and vomiting

Before Calling Emergency

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Poison Control

The local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.

What to Expect at the Emergency Room

Take the container to the hospital with you, if possible.

Your health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• CT scan
• Electrocardiogram (ECG)

Treatment may include:

• Fluids through a vein (by IV)
• Medicine called an antidote to reverse the effects of the poison and treat symptoms, such as sodium bicarbonate
• Activated charcoal
• Laxative
• Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Outlook (Prognosis)

An overdose of amitriptyline and perphenazine can be very serious.

People who swallow too much of this medicine are almost always admitted to the hospital.

How well someone does depends on how much of the medicine was swallowed and how quickly treatment is given. The faster a person gets medical help, the better the chance of recovery. Complications such as heart rhythm disturbances, pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. Death can occur.

References

Aronson JK. Tricyclic antidepressants. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:146-169.

Levine MD, Ruha A-M. Antidepressants. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 141.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Nelson LS, Calello DP. Acute poisoning. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 96.

Review Date: 10/14/2025  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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