Trazodone toxicity
Background
- Trazodone is extremely safe in overdose as long as there are no coingestants
- Has serotonergic and alpha blocking effects
Clinical Features
- CNS depression
- Most common symptom
- Rarely produces coma or seizures when it is the only drug ingested
- Respiratory depresion
- Fairly common (but only with coingestants)
- Orthostatic hypotension
- QT prolongation
Differential Diagnosis
Evaluation
Management
- GI decontamination
- Activated charcoal x1
- Gastric lavage (consider for coingestants)
- QT prolongation
- Treat torsades in usual manner
- Hypotension
- IVF
- Norepinephrine
- Dopamine is contraindicated
Disposition
- Consider discharge for patients who remain asymptomatic for at least 6 hours