IMIPRAMINE OVERDOSE COMPLICATED BY TOXIC MEGACOLON

Tricyclic antidepressants are a class of drugs commonly used for the t reatment of depression. Tricyclic antidepressants account for approxim ately 20 Co 25 per cent of drug overdoses that require acute medical a dmission. The most common cause of mortality is cardiovascular toxicit y (e,g., arrhythmia, heart block, or hypotension), Other morbidities i nclude conditions secondary to anticholinergic effects (central and pe ripheral) and respiratory complications. Ileus, constipation and urina ry retention are common peripheral anticholinergic sequelae, whereas u nusual complications include pancreatitis, intestinal pseudo-obstructi on with cecal perforation, and sigmoid colon gangrene. We report a cas e of imipramine overdose that was complicated by toxic megacolon with an associated perforation.