Selective serotonin reuptake inhibitor toxicity: Difference between revisions

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*QRS, [[QT prolongation]] (citalopram only)
*QRS, [[QT prolongation]] (citalopram only)
*[[Serotonin syndrome]]
*[[Serotonin syndrome]]
*Coma and seizures (rare)
*[[Coma]] and [[seizures]] (rare)


==Differential Diagnosis==
==Differential Diagnosis==
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==Management==
==Management==
*Supportive care
*Supportive care
*No role for activated charcoal or gastric lavage  
*No role for [[activated charcoal]] or gastric lavage  
*Magnesium sulfate 2g IV if QTc > 500 msec
*[[Magnesium]] sulfate 2g IV if QTc > 500 msec
*IV benzodiazepines if agitation or seizures
*IV [[benzodiazepines]] if agitation or seizures


==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 ingestion
*ECG before clearing a patient with citalopram ingestion


==See Also==
==See Also==

Revision as of 14:32, 1 September 2019

Background

  • Most serious adverse effect is potential to produce Serotonin Syndrome
  • Fatalities are uncommon with pure overdoses

Clinical Features

Differential Diagnosis

Anticholinergic toxicity Causes

Management

Disposition

  • Consider admission for patients who are tachycardic or lethargic 6hr after ingestion
  • ECG before clearing a patient with citalopram ingestion

See Also

References

  1. Dawson AH, Buckley NA. Pharmacological management of anticholinergic delirium – theory, evidence and practice. Br J Clin Pharmacol. 2015;81(3):516-24.