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Related Experiment Videos

Citalopram Overdose: a Fatal Case.

Erik P Kraai1, Steven A Seifert

  • 1University of New Mexico Health Sciences Center, MSC09 5080, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|October 19, 2014
PubMed
Summary
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A fatal citalopram overdose case highlights severe toxicity risks. High-dose selective serotonin reuptake inhibitor (SSRI) ingestions can lead to fatal outcomes, emphasizing the need for close monitoring.

Area of Science:

  • Toxicology
  • Cardiology
  • Neurology

Background:

  • Citalopram, a selective serotonin reuptake inhibitor (SSRI), presents risks of cardiac and neurologic toxicity, and serotonin syndrome.
  • While most SSRI overdose cases resolve fully, severe outcomes, including fatalities, can occur.

Observation:

  • A 35-year-old woman presented with witnessed seizures following a suspected intentional citalopram overdose.
  • She experienced cardiac arrest, seizures, and rapid-onset fever, progressing to torsades des pointes and death despite resuscitation efforts.
  • Postmortem analysis revealed a citalopram concentration significantly exceeding therapeutic levels.

Findings:

  • High-dose citalopram ingestion can cause severe QTc prolongation, torsades des pointes, seizures, and serotonin syndrome.

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  • The patient exhibited symptoms consistent with serotonin syndrome, including increased muscle tone and autonomic dysregulation.
  • Massive citalopram overdose, as indicated by serum concentration, correlated with severe clinical effects and a fatal outcome.

    • Implications:

    • Clinicians must recognize the potential for life-threatening effects from large citalopram ingestions.
    • Close monitoring for neurologic and cardiovascular manifestations is crucial in managing severe SSRI overdose cases.
    • Delayed presentation may significantly contribute to mortality in severe citalopram overdose cases.