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Acute fluvoxamine poisoning
R Garnier1, P Azoyan, D Chataigner
1Paris Poisons Centre, University of Paris VII, France.
The Journal of International Medical Research
|July 1, 1993
Summary
Fluvoxamine overdose is rarely severe, especially below 1000 mg. Symptoms are typically mild, with seizures and cardiotoxicity uncommon even in high-dose fluvoxamine (Selective Serotonin Reuptake Inhibitor) overdoses.
Area of Science:
- Pharmacology
- Clinical Toxicology
Background:
- Selective Serotonin Reuptake Inhibitors (SSRIs) are widely prescribed.
- Understanding the acute toxicity profile of SSRIs like fluvoxamine is crucial for clinical management.
Purpose of the Study:
- To analyze the clinical effects and toxicity of deliberate acute fluvoxamine overdose.
- To assess the severity of fluvoxamine toxicity, particularly in relation to co-ingested substances.
Main Methods:
- Retrospective analysis of 221 cases reported to the Paris Poison Centre.
- Inclusion of 78 cases from Duphar BV's International Drug Safety Department.
- Evaluation of co-ingestion patterns with other substances like benzodiazepines, neuroleptics, other antidepressants, and alcohol.
Main Results:
- Fluvoxamine alone rarely caused severe acute toxicity.
- Doses below 1000 mg typically resulted in benign symptoms (drowsiness, tremor, nausea, vomiting, abdominal pain, bradycardia, anticholinergic effects).
- Seizures and cardiotoxicity (moderate bradycardia, rare conduction abnormalities) were infrequent and associated with higher doses (>1500 mg).
Conclusions:
- Acute fluvoxamine overdose generally exhibits low toxicity.
- Management strategies should consider potential co-ingestions.
- Fluvoxamine appears to have a relatively safe profile in acute overdose scenarios.