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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
|March 2, 2023
Summary
Cognitive disorders increase medication misuse risk. Early intoxication screening in patients with hypothermia and coma is crucial, even without typical toxidrome signs.
Area of Science:
- Toxicology
- Geriatric Medicine
- Emergency Medicine
Background:
- Cognitive disorders are associated with a higher risk of medication misuse and accidental self-poisoning.
- Accidental intoxication poses a significant risk, particularly in vulnerable populations.
Observation:
- A case of a 68-year-old patient presenting with hypothermia and coma due to accidental tricyclic antidepressant (TCA) intoxication is detailed.
- Notably, the patient exhibited no typical cardiac or hemodynamic abnormalities often associated with TCA overdose and hypothermia.
Findings:
- Intoxication should be a key consideration for patients presenting with hypothermia and altered consciousness, alongside neurological or metabolic etiologies.
- Thorough patient history, including cognitive status, is vital for accurate diagnosis.
- Early screening for intoxication is recommended for individuals with cognitive disorders, coma, and hypothermia, irrespective of classic toxidrome presentation.
Implications:
- This case highlights the importance of considering intoxication in patients with hypothermia and decreased consciousness, especially those with cognitive impairments.
- Healthcare providers should maintain a high index of suspicion for TCA intoxication, even in atypical presentations.
- Prompt recognition and screening can lead to timely intervention and improved patient outcomes in cases of accidental poisoning.
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