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Isolated atomoxetine overdose resulting in seizure
John Kashani1, Anne-Michelle Ruha
1Banner Good Samaritan Medical Center Phoenix, Arizona, USA.
The Journal of Emergency Medicine
|February 20, 2007
Summary
Atomoxetine overdose can cause seizures and mild cardiac toxicity. This case highlights the importance of recognizing these potential adverse effects in emergency settings.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Medicine
Background:
- Atomoxetine (Strattera) is approved for Attention Deficit Hyperactivity Disorder (ADHD) treatment in adolescents and adults.
- Atomoxetine functions as a norepinephrine reuptake inhibitor.
- Limited data exists on atomoxetine's effects in overdose scenarios.
Observation:
- A 17-year-old female presented with a seizure and sinus tachycardia (110 bpm, QRS 93 ms) following a 2840 mg atomoxetine ingestion.
- Urine toxicology confirmed atomoxetine, naproxen, and nicotine; serum levels were 1995 ng/ml for atomoxetine and 12 mcg/L for naproxen.
- The patient experienced progressive symptom improvement and was asymptomatic within 24 hours, with repeat ECG showing a normalized QRS interval (79 ms).
Findings:
- This case report details an isolated atomoxetine overdose leading to central nervous system toxicity (seizure) and mild cardiac toxicity (transient QRS widening).
- The patient's serum atomoxetine level was significantly elevated, correlating with the observed toxic effects.
Implications:
- Clinicians should be aware of the potential for atomoxetine overdose to induce seizures and cardiac abnormalities.
- Prompt recognition and supportive care are crucial for managing atomoxetine toxicity.
- Further research into the dose-dependent toxicity of atomoxetine is warranted.
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