Two lessons from the empiric management of a combined overdose of liraglutide and amitriptyline.

We report the case of a 52-year-old man with a combined liraglutide and amitriptyline overdose who presented with a seizure and then pulseless electrical activity cardiac arrest. This is the largest reported overdose of liraglutide (36 mg), a novel glucagon-like peptide-1 analog recommended for certain patients with type 2 diabetes mellitus. The subsequent biochemical effects included severe electrolyte disturbances associated with polyuria. Regarding the amitriptyline, treatment with lipid emulsion correlated with resolution of electrocardiographic changes and successful resuscitation. The treatment of amitriptyline overdose with lipid emulsion is briefly discussed.