Editing Amitriptyline (section)

==Overdose==
{{Main|Tricyclic antidepressant overdose}}
The symptoms and the treatment of an overdose are largely the same as for the other TCAs, including the presentation of [[serotonin syndrome]] and adverse cardiac effects. The [[British National Formulary]] notes that amitriptyline can be particularly dangerous in overdose,<ref name = BNF>{{cite book | author = Joint Formulary Committee | title = British National Formulary (BNF) | year = 2013 | url = https://archive.org/details/bnf65britishnati0000unse | isbn = 978-0-85711-084-8 | edition = 65th | location = London, UK | publisher = Pharmaceutical Press | url-access = registration }}</ref> thus it and other TCAs are no longer recommended as first-line therapy for depression. The treatment of overdose is mostly supportive as no specific antidote for amitriptyline overdose is available. Activated charcoal may reduce absorption if given within 1–2 hours of ingestion. If the affected person is unconscious or has an impaired gag reflex, a nasogastric tube may be used to deliver the activated charcoal into the stomach. ECG monitoring for cardiac conduction abnormalities is essential and if one is found close monitoring of cardiac function is advised. Body temperature should be regulated with measures such as heating blankets if necessary. Cardiac monitoring is advised for at least five days after the overdose. [[Benzodiazepines]] are recommended to control seizures. [[Haemodialysis|Dialysis]] is of no use due to the high degree of [[Plasma protein binding|protein binding]] with amitriptyline.<ref name=TGA>{{cite web|title=Endep Amitriptyline hydrochloride|date=10 December 2012|access-date=1 December 2013|url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-04558-3|format=PDF|work=TGA eBusiness Services|publisher=Alphapharm Pty Limited|url-status=live|archive-url=https://web.archive.org/web/20170813145944/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-04558-3|archive-date=13 August 2017}}</ref>