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Diagnostic pitfalls associated with amoxapine overdose: a case report
M V Miles1, R S Greenwood, B Hussey
1Division of Pharmacy Practice, School of Pharmacy, University of North Carolina, Chapel Hill 27599.
The American Journal of Emergency Medicine
|July 1, 1990
Summary
Amoxapine overdose can cause serious medical issues, including seizures, in children. A 9-year-old experienced seizures, initially mistaken for epilepsy, but was diagnosed with amoxapine poisoning after admitting ingestion.
Area of Science:
- Toxicology
- Pediatric Neurology
- Clinical Case Reports
Background:
- Amoxapine, a second-generation antidepressant, is known to cause severe adverse events in overdose scenarios.
- These events include seizures, acidosis, cardiac dysrhythmias, hypotension, renal failure, coma, and cardiorespiratory arrest.
- Accidental or intentional poisoning requires prompt recognition and management.
Observation:
- A previously healthy 9-year-old child presented with generalized tonic-clonic seizures.
- Extensive workup for primary generalized epilepsy was negative, with no history or lab findings suggesting toxin ingestion.
- The correct diagnosis of amoxapine poisoning was made 48 hours after admission when the child confessed to ingesting her mother's medication.
Findings:
- Amoxapine poisoning can mimic primary neurological disorders like epilepsy in children.
- Diagnostic delays can occur due to the lack of initial suspicion for toxin exposure.
- The case highlights the potential severity of amoxapine toxicity in pediatric populations.
Implications:
- Clinicians must consider amoxapine poisoning in pediatric patients presenting with seizures, especially when the etiology is unclear.
- Awareness of amoxapine's toxicity profile is crucial for timely diagnosis and appropriate treatment.
- This case underscores the importance of thorough patient history and considering environmental factors in pediatric emergencies.