Treatment of imipramine intoxication

Sodium bicarbonate treatment for tricyclic antidepressant arrhythmias in children

Sodium bicarbonate has modified or reversed arrhythmias due to tricyclic antidepressants in 11 children. It has proved to be the most clinically effective method of treatment of these arrhythmias in children, and reference is made to experimental studies which support this view.

The use of sodium bicarbonate in the treatment of tricyclic antidepressant-induced arrhythmias

Sodium bicarbonate has been successfully used clinically to treat arrhythmias induced by tricyclic antidepressant drugs (imipramine, amitriptyline, nortriptyline, dibenzepin). Experiments conducted on puppies showed that arrhythmias caused by amitriptyline disappear when acidosis is adequately treated. Plasma protein binding of amitriptyline increases as pH rises, reducing the unbound fraction of drug. This mechanism is an important factor in the antiarrhythmic action of sodium bicarbonate in tricyclic antidepressant overdosage.