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[Antidepressant overdose resulting in coma and hypothermia]
Linda J de Vries1,2, Jeroen Boekema3, Rahmat Sediq4
1Medisch Centrum Leeuwarden, Leeuwarden: Afd. Spoedeisende Hulp.
Nederlands Tijdschrift Voor Geneeskunde
|May 2, 2022
Summary
Cognitive disorders increase medication misuse risk. Early intoxication screening is vital for patients with hypothermia and coma, even without typical toxidrome signs.
Area of Science:
- Toxicology
- Emergency Medicine
- Geriatrics
Background:
- Cognitive disorders are linked to a higher risk of medication misuse and accidental self-poisoning.
- Accurate patient history, including cognitive status, is crucial for diagnosis.
Observation:
- A 68-year-old patient presented with hypothermia and coma due to accidental tricyclic antidepressant (TCA) intoxication.
- Notably, the patient lacked typical cardiac and hemodynamic abnormalities often associated with TCA overdose and hypothermia.
Findings:
- Intoxication should be suspected in patients with hypothermia and altered consciousness, alongside neurological or metabolic conditions.
- The absence of a classic toxidrome does not rule out poisoning.
Implications:
- Early screening for intoxication is recommended for patients with cognitive disorders presenting with coma and hypothermia.
- This case highlights the importance of considering poisoning in undifferentiated presentations of hypothermia and altered mental status.
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