Citalopram overdose
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Various toxicities: case report A 33-year-old man developed drowsiness, recurrent generalised tonic-clonic seizure, nonspecific ST-T changes, prolonged QT interval and decreased level of consciousness following the ingestion of citalopram at an overdose in a suicide attempt. The man presented with a complaint of drowsiness and referred to the poisoning department of Khorshid Hospital, Iran. His history stated that he had ingested 40 tablets of citalopram (equal to 40mg) an hour before the presentation in a suicide attempt. On arrival, he was found to be conscious and his investigations showed as follows: BP 100/70mm Hg, RR 18 /min, HR 86 bpm, SpO2 99% on room air and temperature 37°C. Ten minutes after admission, he developed a generalised tonic-clonic seizure. The man’s generalised tonic-clonic seizure was lasted for 2 minutes and resolved without treatment. Additionally, prolonged QT interval and nonspecific ST-T changes were noted on the ECG examination. Following in the conscious state, the nasogastric tube was inserted and he underwent gastric lavage and charcoal therapy. His clinical examination showed right shoulder dislocation. Subsequent portable X-ray confirmed the bilateral anterior shoulder dislocation along with right proximal humerus fracture. One hour later, he developed a second episode of tonic-clonic seizure, which was managed with diazepam. In view of decreased O2 saturation and level of consciousness, and risk of aspiration, he was intubated and administered unspecified sedative [exact duration of ingestion to reactions onsets not stated]. Thereafter, he was transferred to the ICU and started on mechanical ventilation. Under sedation, his right shoulder dislocation was reduced. His brain CT scan was found to be normal. Two days later, he was discharged with full recovery and referred to the orthopaedic and psychiatric departments for follow-up. Zoofaghari S, et al. Massive citalopram overdose associated with recurrent seizures and bilateral shoulder dislocations. Journal of Research in Pharmacy Practice 9: 161-164, No. 3, Sep 2020. Available from: URL: http://doi.org/10.4103/jrpp.JRPP_20_24 803514254
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Reactions 14 Nov 2020 No. 1830
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