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Chlorpromazine overdose: a case series.

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Chlorpromazine overdose can lead to central nervous system depression. Higher reported doses of chlorpromazine, especially when taken alone, are significantly associated with the need for endotracheal intubation.

Keywords:
Chlorpromazineantipsychoticendotracheal intubationoverdosepoisoningpsychotropic

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Area of Science:

  • Toxicology
  • Pharmacology
  • Emergency Medicine

Background:

  • Chlorpromazine is an established antipsychotic medication with continued use.
  • Overdoses of chlorpromazine present a significant clinical challenge.
  • Understanding overdose effects is crucial for patient management.

Purpose of the Study:

  • To investigate the clinical effects of chlorpromazine overdose.
  • To determine the relationship between ingested dose and ICU admission or intubation.

Main Methods:

  • Retrospective analysis of 218 patients with chlorpromazine overdose (ingestion > 300 mg).
  • Data collected: demographics, ingestion details, clinical effects (GCS, hypotension, delirium, dysrhythmias), ICU admission, and intubation.
  • Analysis spanned from 1987 to 2023.

Main Results:

  • Median reported dose was 1,250 mg; 62% involved co-ingestions.
  • 23% of patients were admitted to the intensive care unit (ICU), and 15% required endotracheal intubation.
  • Higher reported doses significantly correlated with ICU admission and intubation (P < 0.001).

Conclusions:

  • Central nervous system depression is the primary effect of chlorpromazine overdose.
  • Endotracheal intubation is associated with higher reported doses, particularly in single-drug ingestions.
  • Both presentation frequency and reported dose declined post-2013.