ROBERT H. BRIER, M.D.
To the editor: Doctor Hollister's excellent review, "Treatment of Depression with Drugs" (Ann Intern Med 89:78-84, 1978), suggests that treatment of tricyclic overdosage with physostigmine is limited to an arbitrary total intravenous dose of 3 to 4 mg. Yet a number of authors have reported cases of successful treatment of tricyclic overdosage requiring up to 74 mg of physostigmine (1). I am aware of a 7-year-old child having been successfully treated for Tofranil® ingestion with a total dose of 260 mg of physostigmine during a 30-h period, including a continuous intravenous infusion of the drug at 16 mg/h at one
BRIER RH. Physostigmine Dose for Tricyclic Drug Overdose. Ann Intern Med. ;89:579. doi: 10.7326/0003-4819-89-4-579_2
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Published: Ann Intern Med. 1978;89(4):579.
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