This case report details an intentional overdose attempt utilizing tricyclic antidepressants (TCAs) and atypical antipsychotics with significant neurologic, pulmonary, and cardiac toxicity. In conjunction with the local poison control center, progression of the clinical toxidrome was anticipated, aggressively managed, and successfully treated. This case highlights the dangers of significant TCA toxicity, peak onset of toxicity within six hours, and the amplification of clinical toxidromes with co-ingestions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293789 | PMC |
http://dx.doi.org/10.7759/cureus.63691 | DOI Listing |
J Oral Facial Pain Headache
September 2024
Department of Pediatric Dentistry, Barzilai Medical Center, 7830604 Ashkelon, Israel.
Chronic intraoral neuropathic pain (NP), often developing post-dental procedures, poses significant management challenges. The prevalent use of systemic treatments, with their frequent substantial side effects, emphasizes the need for alternative therapeutic strategies. Our aim is to explore the efficacy and adherence with a topical drug regimen delivered through a neurosensory stent (NS) for treating chronic neuropathic pain (NP) within the oral cavity.
View Article and Find Full Text PDFJ Clin Med
December 2024
Emergency Medicine, Freeman Health System, Joplin, MO 64804, USA.
Sodium bicarbonate has been used in the treatment of different pathologies, such as hyperkalemia, cardiac arrest, tricyclic antidepressant toxicity, aspirin toxicity, acute acidosis, lactic acidosis, diabetic ketoacidosis, rhabdomyolysis, and adrenergic receptors' resistance to catecholamine in patients with shock. An ongoing debate about bicarbonate's efficacy and potential harm has been raised for decades because of the lack of evidence supporting its potential efficacy. Despite the guidelines' restrictions, sodium bicarbonate has been overused in clinical practice.
View Article and Find Full Text PDFBiomedicines
November 2024
Centro Universitario de Los Lagos, Universidad de Guadalajara, Lagos de Moreno 47460, Jalisco, Mexico.
Pharmacotherapy for depression includes drugs such as monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), noradrenaline (NA) and serotonin (5-HT) reuptake inhibitors (NaSSAs), and atypical antidepressants; these drugs exert differentially beneficial effects on symptoms of depression after acute and chronic treatment in animal models. Said effects are established through neuroplastic mechanisms involving changes in neurogenesis and synaptogenesis as result of the activation of intracellular signaling pathways associated with neurochemical and behavioral changes. Antidepressants increase the synaptic availability of monoamines (monoaminergic hypothesis) such as 5-HT, NA, and gamma-aminobutyric acid (GABA) by inhibiting their reuptake or degradation and activating intracellular signaling pathways such as the responsive element binding protein (cAMP-CREB) cascade, which regulates the expression of genes related to neuroplasticity and neurogenesis, such as brain-derived neurotrophic factor (BDNF), in various brain structures implicated in depression.
View Article and Find Full Text PDFCNS Spectr
January 2025
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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