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Amitriptyline Overdose Case Used Clonazepam for Myoclonus Within Complex Intensive Care
A severe antidepressant-poisoning report described serotonin-syndrome-like signs and later neuromuscular weakness. Clonazepam was one component of treatment rather than a tested antidote.
A severe antidepressant-poisoning report described serotonin-syndrome-like signs and later neuromuscular weakness. Clonazepam was one component of treatment rather than a tested antidote.
The clinical course
The patient developed altered consciousness, hyperthermia, acidosis, and QRS prolongation after a large amitriptyline ingestion. Mechanical ventilation, cooling, and alkalinization were used.
Myoclonus prompted treatment including clonazepam, levetiracetam, and cyproheptadine. Aspiration pneumonia, respiratory failure, and later weakness complicated recovery; nerve-conduction findings raised concern for critical illness polyneuropathy.
Separate phases and explanations
The authors described suspected syndromes rather than proving a unique mechanism for every neurologic sign. Several drugs and intensive-care interventions changed together.
This case cannot establish that clonazepam reversed the intoxication or caused the later weakness. It illustrates why initial toxic effects, treatment-related sedation, complications, and later neuromuscular dysfunction need separate timelines. A prolonged recovery should not be attributed to the presence of a benzodiazepine without considering the severe underlying poisoning and intervening illness.
Source paper
Original analysis of the supplied journal article, identified as PMC12862876.