Reactions 1097 - 15 Apr 2006

O SCitalopram overdose

Generalised seizures in an infant followingaccidental overdose: case report

An 10-month old female infant developed generalisedseizures following accidental ingestion of a citalopramoverdose; the citalopram had been prescribed for hergrandmother.

Upon discovering that the infant had ingested an unknownquantity of citalopram tablets (approximately 50 tablets weremissing from the bottle), her mother induced vomiting by gagreflex; pill fragments were observed in the vomitus. Onpresentation at the emergency room, the infant was alert andinteractive, but within 15 minutes of arrival, about 30 minutesafter ingestion, she developed horizontal nystagmus; minimaloral activated charcoal had been administered. Withinminutes, a generalised seizure developed, which lasted3 minutes.

The infant received IM midazolam followed by IVmidazolam and fosphenytoin. She was intubated, and receivedfurther activated charcoal via a nasogastric tube. ECGs at85 minutes and 2 hours postingestion, respectively, showedno abnormal rhythms or intervals. A second seizure of3 minutes’ duration occurred 35 minutes after the first, andshe received IV phenobarbital; a third seizure lasting 1 minuteoccurred 15 minutes later. She was transferred to thepaediatric ICU. During the next 48 hours she awoke. Shesubsequently recovered uneventfully and was dischargedwithout sequelae.Masullo LN, et al. Clinical course and toxicokinetic data following isolatedcitalopram overdose in an infant. Clinical Toxicology 44: 165-168, No. 2, 2006 -USA 801038293

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Reactions 15 Apr 2006 No. 10970114-9954/10/1097-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved