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Updated: Jun 17, 2025
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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
Published on: April 23, 2019
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Analytically Confirmed Intentional Overdose of the Antidepressant Vortioxetine
Adam Daneshmend1, Allon Gould1, Simon Hudson2
1Clinical Toxicology and General Medicine, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
Summary
A patient survived a non-fatal vortioxetine overdose, showing no significant toxicity despite high plasma concentrations. This case highlights the safety of vortioxetine in overdose scenarios, contributing to understanding antidepressant safety.
Area of Science:
- Pharmacology
- Clinical Toxicology
Background:
- Vortioxetine is a multimodal antidepressant for major depressive episodes.
- Limited data exists on vortioxetine overdose, with only two unconfirmed non-fatal cases and two deaths previously reported.
- This report details an analytically confirmed non-fatal vortioxetine overdose.
Observation:
- A 32-year-old male ingested 1,260 mg of vortioxetine and 350 mg of diazepam.
- The patient presented with drowsiness but maintained normal vital signs and consciousness.
- Blood analysis confirmed vortioxetine at 457 ng/mL 10 hours post-ingestion, with sub-therapeutic levels of other substances.
Findings:
- The patient exhibited no significant toxicity or serotonin syndrome features.
- Plasma vortioxetine concentration was approximately 15 times the therapeutic level.
- No clinical or biochemical evidence of serotonin toxicity was observed.
Implications:
- This case suggests a potentially wider safety margin for vortioxetine in overdose than previously assumed.
- Further reporting of confirmed vortioxetine overdoses is crucial for clinical and regulatory understanding.
- This data aids in assessing the overall safety profile of vortioxetine in overdose situations.
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