Reactions 1269 - 12 Sep 2009

O SClomipramine overdose

Seizure: case reportA 41-year-old woman with obsessive-compulsive

disorder (OCD) experienced a seizure, after taking anoverdose of clomipramine in a suicide attempt.

The woman had been treated for (OCD) for 11 years, andhad attempted suicide three other times in the previous2 years. She had most recently been receivingclomipramine 150mg daily. Four hours after ingesting20 clomipramine [Anafranil SR] 75mg slow-release tablets(total ingested 1500mg), she presented to an emergencydepartment. Initially, she was vomiting and hadpalpitations. She was transferred to the ICU, where gastriclavage was started using activated charcoal. An ECGshowed sinus tachycardia. Two hours after admission, sheexperienced a generalised tonic-clonic seizure.

Diazepam was administered and the seizure stopped.The woman’s urine output decreased, and her creatininelevel increased to 1.8 at 24 hours post-admission, beforenormalising after intense hydration. Her mental statusgradually improved, and on day 2 she was fully orientedand able to be transferred to a ward.

Author comment: "As [with] other [tricyclicantidepressants], clomipramine may be toxic in relativelylower doses, compared with other selective serotoninreuptake inhibitors".Gozdemir M, et al. The use of overdose slow release clomipramine-inducedseizures: a case report. Klinik Psikofarmakoloji Bulteni 19 (Suppl. 1): 308-309,2009 - Turkey 801150528

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Reactions 12 Sep 2009 No. 12690114-9954/10/1269-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved