Reactions 1003 - 29 May 2004

O SCitalopram overdose

Generalised seizure and supraventriculartachycardia: case report

A 23-year-old man developed a generalised seizure andsupraventricular tachycardia (SVT) after ingesting an overdoseof citalopram in a suicide attempt.

The man, who had been prescribed citalopram andtrazodone for severe depression and a previous suicideattempt, presented to hospital 1 hour and 40 minutes afteringesting 23 citalopram 40mg tablets (total dose 920mg). Hedenied ingestion of any other agents and reported that he hadnot taken trazodone for 2 days prior to the citalopramoverdose. On presentation, he was alert and calm with normalspeech, and reported no homicidal ideation or auditory orvisual hallucinations. His vital signs and a physicalexamination, including a neurological examination, werenormal. Laboratory investigations showed a normal chemistrypanel and a urine toxicology screen was negative for drugs ofabuse; the screen did not test for tricyclic antidepressants.Forty-five minutes after admission, the man developed ageneralised seizure that lasted approximately 2 minutes andwas treated with IV lorazepam. His post-ictal state lasted10 minutes and a neurological examination was normal afterrecovery. He experienced no further seizures but 20 minutesafter his seizure, he developed SVT with a HR of160 beats/min.

The man was given IV adenosine and his SVT converted to anormal sinus rhythm. He was admitted to the ICU for furthermanagement. A head CT scan was normal and, after 24 hoursof continuous cardiac monitoring, he was transferred topsychiatric care.Cuenca PJ, et al. Seizure secondary to citalopram overdose. Journal of EmergencyMedicine 26: 177-181, No. 2, Feb 2004 - USA 807216661

1

Reactions 29 May 2004 No. 10030114-9954/10/1003-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved