Amitriptyline and perphenazine can be very harmful in large amounts.

Medicines with this brand name contain amitriptyline and perphenazine:

• Triptazine

Other medicines may also contain amitriptyline and perphenazine.

Below are symptoms of an amitriptyline and perphenazine overdose in different parts of the body. These symptoms may occur more often or be more severe in people who also take certain other medicines that affect serotonin, a chemical in the brain.

AIRWAYS AND LUNGS

• Slowed, labored breathing
• No breathing

BLADDER AND KIDNEYS

• Hard to start urinating, and urine stream may be weak
• Inability to completely empty the bladder

EYES, EARS, NOSE, THROAT, AND MOUTH

• Blurred vision
• Dry mouth
• Enlarged pupils
• Eye pain in people at risk for a type of glaucoma
• Nasal congestion
• Unpleasant taste in mouth

HEART AND BLOOD

• Irregular heartbeat
• Low blood pressure (severe)
• Rapid heartbeat
• Shock

MUSCLES AND JOINTS

• Muscles are rigid
• Muscle cramps, spasms, or stiffness of the limbs
• Stiff muscles in neck, face, or back

NERVOUS SYSTEM

• Agitation
• Coma (decreased level of consciousness and lack of responsiveness)
• Seizures
• Delirium
• Disorientation
• Drowsiness
• Lower than normal body temperature
• Restlessness
• Uncoordinated movement
• Tremor
• Weakness

REPRODUCTIVE SYSTEM

• Change in menstrual patterns

SKIN

• Itchy skin
• Rash

STOMACH AND INTESTINES

• Constipation
• Loss of appetite
• Nausea and vomiting

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container to the hospital with you, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• CT scan
• Electrocardiogram (ECG)

Treatment may include:

• Fluids through a vein (by IV)
• Medicine called an antidote to reverse the effects of the poison and treat symptoms, such as sodium bicarbonate or lidocaine
• Activated charcoal
• Laxative
• Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

An overdose of amitriptyline and perphenazine can be very serious.

People who swallow too much of this medicine are almost always admitted to the hospital.

How well someone does depends on how much of the medicine was swallowed and how quickly treatment is given. The faster a person gets medical help, the better the chance of recovery. Complications such as heart rhythm disturbances, pneumonia, muscle damage from lying on a hard surface for a long period of time, or brain damage from lack of oxygen may result in permanent disability. Death can occur.

Triptazine overdose

Aronson JK. Tricyclic antidepressants. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:146-169.

Huffman JC, Beach SR, Stern TA. Side effects of psychotropic medications. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Psychopharmacology and Neurotherapeutics. Philadelphia, PA: Elsevier; 2016:chap 12.

Levine MD, Ruha A-M. Antidepressants. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 141.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.