Amoxapine Overdosage-Reply

Abstract

In Reply.— The Lederle authors, describing our research as incomplete, cite two articles that they believe we have overlooked. The amoxapine overdose series of Kulig et al, 1 however, was cited in our manuscript but never mentions a higher convulsion rate compared with other cyclic antidepressants despite the occurrence of seizures in 100% of the reported patients. Another letter by two of the correspondents 2 had not yet been published when our manuscript was submitted but does state that convulsive seizures after an overdose, although not uncommon with the older TCAs [tricyclic antidepressants], may be more common with amoxapine. Our study populations included all cases reported to the two poison control centers during the 18-month study period. We are unable to identify any reporting bias favoring more severe amoxapine cases as compared with other cyclic antidepressants. Our data include a slightly but not significantly higher percentage of pediatric ingestions in