Difference between revisions of "SSRI toxicity"

(Created page with "==Background== *Most serious adverse effect is potential to produce Serotonin Syndrome *Fatalities are uncommon with pure overdoses ==Clinical Features== *N/V *Sedation *Tr...")
 
 
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==Background==
 
==Background==
 
*Most serious adverse effect is potential to produce [[Serotonin Syndrome]]  
 
*Most serious adverse effect is potential to produce [[Serotonin Syndrome]]  
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==Clinical Features==
 
==Clinical Features==
*N/V
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*[[Nausea and vomiting]]
 
*Sedation
 
*Sedation
 
*Tremor
 
*Tremor
*Sinus Tachycardia
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*[[Sinus tachycardia]]
*QRS, QT prolongation (citalopram only)
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*QRS, [[QT prolongation]] (citalopram only)
*[[Serotonin Syndrome]]
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*[[Serotonin syndrome]]
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*[[Coma]] and [[seizures]] (rare)
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 +
==Differential Diagnosis==
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*[[Serotonin syndrome]]
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{{Anticholinergic types}}
  
==Treatment==
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==Management==
*GI decontamination
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*Supportive care
**Activated charcoal x1
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*No role for [[activated charcoal]] or gastric lavage
**Gastric lavage unnecessary
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*[[Magnesium]] sulfate 2g IV if QTc > 500 msec
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*IV [[benzodiazepines]] if agitation or seizures
  
 
==Disposition==
 
==Disposition==
*Consider admission for patients who are tachycardic or lethargic 6hr after ingesion
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*Consider admission for patients who are tachycardic or lethargic 6hr after ingestion
 +
*ECG before clearing a patient with citalopram ingestion
 +
 
 +
==See Also==
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*[[Serotonin syndrome]]
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*[[SNRI Toxicity]]
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==References==
 +
<references/>
  
==Source==
 
Tintinalli
 
  
[[Category:Tox]]
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[[Category:Toxicology]]

Latest 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.