There has been a report of fatal dysrhythmia occurring as late as 56 hours after amitriptyline overdose. All patients suspected of having taken an overdosage should be admitted to a hospital as soon as possible.
Treatment is symptomatic and supportive.
Empty the stomach as quickly as possible by emesis followed by gastric lavage upon arrival at the hospital. Following gastric lavage, activated charcoal may be administered. Twenty to 30 g of activated charcoal may be given every four to six hours during the first 24 to 48 hours after ingestion. An ECG should be taken and close monitoring of cardiac function instituted if there is any sign of abnormality. The intravenous administration of 1-3 mg of physostigmine salicylate is reported to reverse the symptoms of tricyclic antidepressant poisoning.