Overdose

With the exception of the manifestation of serotonin syndrome and negative cardiac consequences, the signs and symptoms of an overdose are virtually the same as for the other TCAs. Amitriptyline and other TCAs are no longer advised as first-line treatments for depression, according to the British National Formulary, which emphasizes that they can be particularly harmful in overdoses. Since there is currently no known antidote for amitriptyline overdose, supportive care is typically used to treat overdose. If administered within 1-2 hours of eating, activated charcoal may decrease absorption. A nasogastric tube may be used to administer the activated charcoal to the stomach if the affected person is unconscious or has trouble with their gag reflex.

It is crucial to monitor ECGs for cardiac conduction anomalies, and if one is discovered, it is recommended to closely monitor heart function. If necessary, body temperature should be controlled with the use of heating blankets. After the overdose, cardiac monitoring is advised for at least five days. It is advised to use benzodiazepines to prevent seizures. Due to amitriptyline strong protein binding, dialysis is useless.