Compliance with atypical antipsychotic triage guidelines by Texas poison centers

Triage guidelines for poison center management of atypical antipsychotic ingestions were published in December 2007. This investigation determined whether Texas poison centers already complied with a simplified version of these guidelines. All acute aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone ingestions reported to Texas poison centers during 2000-2007 were identified. Exclusion criteria were the presence of coingestants, patient already at or en route to a health-care facility when the poison center was contacted, and chronic ingestion. Each case was evaluated whether it was managed in compliance with the simplified triage guidelines and the compliance rate calculated. For 2,611 total cases, the compliance rate was 64.1%. The rate was 71.7% for aripiprazole, 43.6% for clozapine, 71.6% for olanzapine, 60.8% for quetiapine, 65.5% for risperidone, and 59.0% for ziprasidone. The majority of acute atypical antipsychotic ingestions reported to Texas poison centers were managed according to a simplified version of recommended triage algorithm.