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[Attempted suicide with sustained release diltiazem]

R Quispel1, H J Baur

  • 1Medisch Centrum Haaglanden, locative Westeinde, afd. Intensive Care, Den Haag.

A 15-year-old woman was admitted to the intensive care unit after intentional auto-intoxication with 10 tablets of 200 mg diltiazem sustained release. She developed hypotension and became oliguric. This was followed by metabolic acidosis. Maximum plasma lactate concentration was 10 mmol/l and the highest measured plasma diltiazem level was 500 micrograms/l. The occurrence of pulmonary oedema due to adult respiratory distress syndrome (ARDS) was striking and the patient required mechanical ventilation for a period of three days as a result of this. After five days in the intensive care unit, she was transferred to a psychiatric hospital in a good physical condition. Sustained release diltiazem intoxications have previously been described on five occasions.

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