Amisulpride deliberate self-poisoning causing severe cardiac toxicity including QT prolongation and torsades de
Geoffrey K Isbister1, Lindsay Murray, Sally John
1Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, NT. gsbite@ferntree.com
Abstract:
Although clinical trials of the antipsychotic amisulpride revealed no cardiac adverse effects, four patients with severe cardiac toxicity after overdose were reported to Australian poisons information centres in 2004-2005. All four had QT prolongation over 500 ms, two had rate-dependent bundle branch block, two developed torsades de pointes, and one died after cardiac arrest. Pending further studies, we recommend electrocardiogram assessment until at least 16 h after amisulpride overdose and, if QT interval is prolonged, cardiac monitoring until the patient is clinically well and conduction intervals are normal.
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