Selective serotonin reuptake inhibitor toxicity: Difference between revisions
| Line 25: | Line 25: | ||
==Disposition== | ==Disposition== | ||
*Consider admission for patients who are tachycardic or lethargic 6hr after ingesion | *Consider admission for patients who are tachycardic or lethargic 6hr after ingesion | ||
*ECG before clearing a patient with citalopram ingestion | |||
==See Also== | ==See Also== | ||
Revision as of 14:23, 1 September 2019
Background
- Most serious adverse effect is potential to produce Serotonin Syndrome
- Fatalities are uncommon with pure overdoses
Clinical Features
- Nausea and vomiting
- Sedation
- Tremor
- Sinus tachycardia
- QRS, QT prolongation (citalopram only)
- Serotonin syndrome
- Coma and seizures (rare)
Differential Diagnosis
Anticholinergic toxicity Causes
- Medications[1]
- Atropine
- Antihistamines
- Antidepressants
- Antipsychotics
- Muscle relaxants
- Anti-Parkinsonians
- Plants
- Jimson weed (Devil's trumpet)
- Amanita mushroom
Management
- Supportive care
- No role for activated charcoal or gastric lavage
- Magnesium sulfate 2g IV if QTc > 500 msec
- IV benzodiazepines if agitation or seizures
Disposition
- Consider admission for patients who are tachycardic or lethargic 6hr after ingesion
- ECG before clearing a patient with citalopram ingestion
See Also
References
- ↑ Dawson AH, Buckley NA. Pharmacological management of anticholinergic delirium – theory, evidence and practice. Br J Clin Pharmacol. 2015;81(3):516-24.