Misleading tricyclic antidepressant findings in cases of diphenhydramine overdose: analysis of two instances and a review of existing literature - Report - MDSpire
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Misleading tricyclic antidepressant findings in cases of diphenhydramine overdose: analysis of two instances and a review of existing literature
Clinical Report: Misleading tricyclic antidepressant findings in DPH overdose
Overview
This report discusses two cases of diphenhydramine (DPH) overdose that resulted in false-positive tricyclic antidepressant (TCA) test results. It highlights the implications of these misleading findings for diagnosis and treatment in clinical settings.
Background
The rise in diphenhydramine overdoses, particularly among adolescents in Japan, underscores the importance of accurate drug screening in emergency medicine. Urine drug screening kits currently used do not detect DPH, leading to potential misdiagnosis when false-positive results for TCAs occur. Understanding the mechanisms behind these false positives is crucial for appropriate clinical management.
Data Highlights
No numerical or trial data provided in the article.
Key Findings
['Two cases of DPH overdose presented with false-positive TCA results using the SIGNIFY ER test.', 'Both patients exhibited symptoms consistent with DPH toxicity, including altered consciousness and seizures.', 'False-positive TCA results were confirmed by the manufacturer to occur with DPH overdose.', 'Electrocardiogram findings indicated a mildly prolonged QT interval in one case, raising concerns for arrhythmia.', 'Supportive treatment led to recovery, highlighting the importance of clinical correlation with test results.']
Clinical Implications
Healthcare professionals should be aware of the potential for false-positive TCA results in patients presenting with DPH overdose. Accurate diagnosis should rely on clinical evaluation and confirmatory testing rather than solely on urine drug screening results.
Conclusion
The findings from these cases emphasize the need for caution when interpreting urine drug screening results, particularly in the context of DPH overdose. Clinicians should ensure comprehensive assessments to guide appropriate treatment.
A large audit of biomedical publications suggests fabricated references are increasingly appearing in peer-reviewed papers — often in ways that are difficult for reviewers and readers to detect.
