Amitriptyline hydrochloride overdose

Amitriptyline hydrochloride is a type of prescription medicine called a tricyclic antidepressant. It is used to treat depression. Amitriptyline hydrochloride 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.

Poisonous Ingredient

Amitriptyline can be harmful in large amounts.

Where Found

Amitriptyline hydrochloride is a prescription medicine. It is sold under these brand names:

Adepril
Emitrip
Enovil
Trepiline
Tryptanol
Vanatrip

Other medicines may also contain amitriptyline hydrochloride.

Symptoms

Below are symptoms of an amitriptyline hydrochloride 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

BLADDER AND KIDNEYS

Cannot urinate
Urine does not flow easily

EYES, EARS, NOSE, AND THROAT

Blurred vision
Dilated (wide) pupils
Eye pain in people at risk for a type of glaucoma
Dry mouth

HEART AND BLOOD

NERVOUS SYSTEM

Agitation
Coma
Seizures
Drowsiness
Hallucinations
Headache
Inability to concentrate
Lack of alertness (stupor)
Muscle rigidity or stiffness of the limbs
Restlessness
Uncoordinated movement

STOMACH AND INTESTINES

Constipation
Vomiting

Home Care

This can be a very serious overdose. Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to.

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

Tests that may be done include:

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
Laxatives
Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Outlook (Prognosis)

An amitriptyline hydrochloride overdose 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.

Alternative Names

Adepril overdose; Endep overdose; Enovil overdose; Trepiline overdose

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 AM. 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

Updated 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.