Following intravenous administration of physostigmine salicylate for tricyclic antidepressant poisoning in 21 patients, convulsions occurred in two patients, and severe cholinergic manifestations occurred in two others. Because of these untoward effects and the very short duration of its beneficial action, it is very doubtful that physostigmine has any place in the routine management of tricyclic antidepressant poisoning.
(JAMA 231:941-943, 1975)
Newton RW. Physostigmine Salicylate in the Treatment of Tricyclic Antidepressant Overdosage. JAMA. 1975;231(9):941-943. doi:10.1001/jama.1975.03240210021012