Multiple drugs
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Seizures and other toxicities following drug overdose and poisoning: 37 case reports In a retrospective review of patients (reported to California Poison Control System) admitted between 01 January 2006 and 31 December 2015, 37 patients [including 10 males and 25 females aged 1–63 years; ages and sexes of remaining 2 patients not stated] were described, who developed seizures following poisoning due to venlafaxine overdose. Additionally, two of the 37 patients developed agitation, confusion, hypertension, tachycardia or vomiting following venlafaxine poisoning and overdose, and in 22 patients seizures were also attributed to clonazepam, aripiprazole, diphenhydramine, fluvoxamine, alcohol, bupropion, amfetamine, citalopram, fluoxetine, metamfetamine, quetiapine, paliperidone, paroxetine, lamotrigine, chlordiazepoxide or trazodone [indications and outcomes not stated; not all amounts ingested and times to reaction onsets stated]. The patients were admitted following ingestion of venlafaxine tablets immediate release (16 patients), extended release (19 patients) and unknown (2 patients). Five of the 37 patients ingested 1500–15000mg of venlafaxine. Thirteen patients ingested venlafaxine alone. Twenty two of the 37 patients ingested one or more drugs comprising aripiprazole (2 patients), diphenhydramine (2 patients), aripiprazole and fluvoxamine (1 patient), alcohol [ethanol] (3 patients), bupropion (3 patients), amfetamine [amphetamine] (1 patient), citalopram (1 patient), alcohol and fluoxetine (1 patient), bupropion, metamfetamine [methamphetamine] and quetiapine (1 patient), paliperidone (1 patient), alcohol and lamotrigine (1 patient), chlordiazepoxide, alcohol and trazodone (1 patient), metamfetamine (1 patient), aripiprazole, bupropion and lamotrigine (1 patient), paroxetine (1 patient), and bupropion, clonazepam and alcohol (1 patient). The patients also received multiple co-medications. Upon ingestion, the patients were admitted to the hospital. Due to the ingestion of venlafaxine overdose, the patients developed poisoning, which caused one to five seizure episodes. The co-ingestants also contributed to the seizures in 22 patients. In one of the 37 patients, number of seizure episodes were unknown. Two out of the 37 patients additionally developed adverse effects like vomiting and tachycardia (1 patient), and agitation, confusion, hypertension and tachycardia (1 patient). In 29 of the 37 patients, seizure episodes occurred >7 hours following ingestion of venlafaxine overdose. No patient developed seizure episode 24 hours following the ingestion of venlafaxine overdose. Six of the 37 patients died due to causes unrelated to the seizure activity. The causes of deaths in 6 patients were cardiac arrest (1 patient), sepsis and refractory acute respiratory distress syndrome (1 patient), multi-organ system dysfunction and cardiac arrest (1 patient), and ventricular arrhythmia and cardiac arrest (3 patients). Thirteen of the 37 patients received charcoal [activated charcoal] for decontamination. Vo KT, et al. Se
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