Tricyclic antidepressant poisoning treated by magnesium sulfate: a randomized, clinical trial.
Study Goal
The researchers aimed to compare the effectiveness of sodium bicarbonate alone versus sodium bicarbonate combined with magnesium sulfate in treating tricyclic antidepressant (TCA) poisoning.
Results Summary
The study found that adding magnesium sulfate to sodium bicarbonate treatment significantly reduced ICU stay duration (25.63 vs. 82.67 hours) and showed a trend toward lower mortality (13.9% vs. 33.3%), though the latter was not statistically significant (P=0.052).
Population
Patients with TCA intoxication referred to Loghman Hakim Hospital Poison Center.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Sodium bicarbonate | neutral | TCA poisoning | patients with TCA intoxication | - | is the drug of choice | #1 |
Magnesium sulfate | neutral | TCA poisoning | patients with TCA intoxication | - | seems to be effective | #2 |
Magnesium sulfate infusion in addition to bicarbonate treatment | decrease | mean duration of intensive care unit stay | patients with TCA intoxication | 25.63 ± 9.33 hours vs 82.67 ± 21.66 hours | reduced | #3 |
Magnesium sulfate infusion in addition to bicarbonate treatment | decrease | mortality rate | patients with TCA intoxication | 13.9% vs 33.3% | reduced | #4 |
Magnesium sulfate | neutral | TCA poisoning | patients with TCA intoxication | - | can be an effective drug | #5 |
Tricyclic antidepressant (TCA) poisoning is a major problem in medicine, with a high morbidity and mortality rate. The main cause of fatality is cardiac arrhythmias resulting from intoxication. Sodium bicarbonate is the drug of choice, but severe poisoning necessitates further interventions. Magnesium sulfate seems to be effective in this condition. In a randomized, clinical trial, we evaluated all patients with a history of TCA intoxication referred to the Loghman Hakim Hospital Poison Center. The patients were randomly divided into two groups: one treated by bicarbonate infusion (control group) and the other (case group) by the infusion of magnesium sulfate in addition to the treatment in the first group. Seventy-two patients were recruited into the study (36 cases and 36 controls). Mean duration of intensive care unit stay in the cases and controls were 25.63 ± 9.33 and 82.67 ± 21.66 hours, respectively (P < 0.001). Mortality rate in the case group was 13.9% and 33.3% in the other group (P = 0.052). Magnesium sulfate can be an effective drug in the treatment of TCA poisoning; however, several randomized, clinical trials are still necessary to confirm this.