Abstract
Background. Psychiatric consultation is necessary for all patients with intentional poisoning and its reliability depends on the proper function of patients' memory performance. This study aimed to determine the possible memory impairment following acute TCAs' poisoning. Materials and Methods. In this cross-sectional study, patients with acute TCAs poisoning were allocated to two groups of severe poisoning (with coma, seizures, cardiac arrhythmias, hypotension, and a wide QRS complex) and mild-to-moderate poisoning according to their clinical presentation at the time of hospital admission. All patients underwent memory performance test both immediately and 24 hours after their initial consciousness after admission, using Wechsler Memory Scale (WMS-IV). Results. During the study period, 67 TCA-poisoned patients (aged, 20–64 years) were evaluated, of which 67.2% were female. The mean memory scores of patients immediately and 24 hours after the initial consciousness were 31.43 ± 9.02 and 50.62 ± 9.12, respectively (P < 0.001). Twenty-four hours after the initial consciousness, memory score was statistically correlated with the amount of ingested drug and the intoxication severity. Conclusion. Following the recovery from somatic symptoms of acute TCA poisoning, patients may still suffer from memory impairment and it seems that this time is not suitable for performing a reliable psychiatric consultation.
Highlights
There are limited studies about memory impairment following drug overdose
Memory deficit following drug overdose is an important issue considering that all patients with intentional poisoning will undergo psychiatric consultation after symptoms resolution and before hospital discharge in order to evaluate the possible cause of suicide attempt
At the time of initial consciousness, memory score had no correlation with patient gender, age, and severity of intoxication while it had a correlation with drug dosage
Summary
There are limited studies about memory impairment following drug overdose. From years ago it was found that following benzodiazepines overdose memory impairment will occur [1,2,3] which can remain for more than 24 hours after patient consciousness as anterograde memory impairment [2]. Memory deficit following drug overdose is an important issue considering that all patients with intentional poisoning will undergo psychiatric consultation after symptoms resolution and before hospital discharge in order to evaluate the possible cause of suicide attempt. Depression Research and Treatment if TCAs’ poisoning causes anterograde memory impairment, the validity of the psychiatric counseling would be questionable and patients may not get the psychiatric advisory content effectively at the time of their discharge. In this case, psychiatric counselor can provide the patients and his/her relatives with written information about arrangements made for further managing suicidality and treatment [11]. Following the recovery from somatic symptoms of acute TCA poisoning, patients may still suffer from memory impairment and it seems that this time is not suitable for performing a reliable psychiatric consultation
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