Single-Substance SSRI Intoxication: A Clinical and Outcome Profile Presentation in a Poisoning Referal Center

Area of Science:

• Toxicology
• Cardiology
• Clinical Pharmacology

Background:

• Growing concerns regarding selective serotonin reuptake inhibitor (SSRI) poisoning.
• Potential for serotonin syndrome (SS) and QT-prolonging effects of SSRIs.
• Need to evaluate clinical outcomes of single SSRI overdoses.

Purpose of the Study:

• To assess clinical presentations and outcomes of patients with single SSRI overdoses.
• To identify common symptoms, ECG findings, and complications.
• To determine the incidence of serotonin syndrome and QT prolongation.

Main Methods:

• Cross-sectional study at a Poisoning Emergency referral center.
• Inclusion of 101 patients hospitalized for single SSRI overdose (Jan 2021-Jan 2024).
• Data collection on demographics, toxicology, symptoms, ECG, and outcomes.

Main Results:

• Sertraline and fluoxetine were the most common SSRIs ingested.
• Gastrointestinal symptoms were most frequent; serotonin syndrome occurred in 5.9% of patients.
• QT prolongation was observed in 31.6% of patients; all patients survived.

Conclusions:

• Single SSRI overdoses generally lead to mild to moderate clinical effects.
• Cardiac abnormalities, particularly QT prolongation, are relatively common.
• Severe complications like serotonin syndrome are infrequent in single SSRI overdoses.