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Related Experiment Videos

Nefazodone poisoning: toxicokinetics and toxicodynamics using continuous data collection.

Geoffrey K Isbister1, L Peter Hackett

  • 1University of Newcastle, Newcastle, Australia. gsbite@bigpond.com

Journal of Toxicology. Clinical Toxicology
|May 8, 2003
PubMed
Summary

Nefazodone overdose can cause significant drowsiness, hypotension, and bradycardia. Cardiac toxicity, including prolonged QT intervals, may be concentration-dependent, requiring careful monitoring.

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Area of Science:

  • Pharmacology
  • Toxicology
  • Clinical Medicine

Background:

  • Nefazodone overdose is infrequently reported.
  • Common symptoms include drowsiness, nausea, dizziness, and vomiting, with less frequent hypotension and bradycardia.

Observation:

  • A case of single-agent nefazodone poisoning in a 16-year-old female who ingested 2.4 g.
  • Clinical effects, including significant drowsiness, hypotension (lasting 18 hours), and mild bradycardia, were documented.
  • Serial drug concentrations of nefazodone and its metabolite, hydroxy(OH)-nefazodone, were measured.

Findings:

  • The patient experienced prolonged QT/QTc intervals, which normalized within 24 hours.
  • Terminal elimination half-lives were 8.3 hours for nefazodone and 14.6 hours for OH-nefazodone.

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  • Significant correlations were found between systolic blood pressure and OH-nefazodone, and between QT interval and both nefazodone and OH-nefazodone concentrations.

    • Implications:

    • Nefazodone overdose can lead to concentration-dependent cardiac toxicity.
    • Hypotension, bradycardia, and drowsiness are key clinical effects, peaking within the first 12 hours.
    • This case highlights the potential for nefazodone to cause cardiac abnormalities, warranting further investigation and careful patient management.