Selective serotonin reuptake inhibitor toxicity: Difference between revisions
| Line 18: | Line 18: | ||
==Management== | ==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== | ==Disposition== | ||
Revision as of 14:21, 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
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.