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Generalized Convulsions as the Presenting Sign of Amoxapine Intoxication

Departments of Pediatrics, Pharmacology, and Internal Medicine, The University of Virginia, School of Medicine, Charlottesville, Virginia

Robert Schoumacher

Departments of Pediatrics, Pharmacology, and Internal Medicine, The University of Virginia, School of Medicine, Charlottesville, Virginia

Daniel A. Spyker

Departments of Pediatrics, Pharmacology, and Internal Medicine, The University of Virginia, School of Medicine, Charlottesville, Virginia

Two infants presented for medical evaluation with sudden onset of seizures or coma, without obvious cause. Suspicious circumstances led to toxicological screening analysis. Amoxapine, a recently released antidepressant, was found in the gastric contents of both children an undetermined time after the putative ingestion, but elevated serum concentrations were noted only in one. The pharmacokinetics are described.

There were no obvious cardiotoxic or anticholinergic effects in these infants. Thus, they, like older children and adults, manifest mainly central nervous system toxicity rather than the cardiotoxicity and anticholinergic effects of overdose seen with tricyclic antidepressants.

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