Fluoxetine overdose-induced seizure

Area of Science:

• Clinical Toxicology
• Emergency Medicine
• Pharmacology

Background:

• Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine are commonly prescribed antidepressants.
• While generally safe, SSRI overdose can lead to various adverse effects.
• Seizures are a known, albeit uncommon, complication of significant fluoxetine ingestion.

Purpose of the Study:

• To report a case of generalized seizure following a large intentional overdose of fluoxetine.
• To highlight the potential for seizures in the context of significant fluoxetine toxicity.
• To emphasize the importance of considering seizures in patients presenting after intentional overdose of fluoxetine.

Main Methods:

• Case report of a 37-year-old female patient.
• Review of patient's presentation in the Emergency Department.
• Documentation of witnessed generalized seizure three hours post-ingestion of approximately 1400 mg fluoxetine.

Main Results:

• The patient experienced a generalized seizure after ingesting a large dose of fluoxetine.
• The seizure occurred three hours after the overdose, indicating a delayed onset.
• This event underscores that large intentional fluoxetine overdoses can precipitate seizures.

Conclusions:

• Intentional overdose of fluoxetine, even in the absence of other reported toxicity, can lead to seizures.
• Emergency Department physicians should maintain a high index of suspicion for seizures in patients with significant fluoxetine overdose.
• This case contributes to the understanding of fluoxetine's toxicity profile in massive ingestions.