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Mixed fluoxetine/loxapine overdose and atrial flutter

R J Roberge¹, T G Martin

¹Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania.

Annals of Emergency Medicine

|March 1, 1994

Summary

This case study highlights potential cardiotoxicity from overdoses of fluoxetine (Prozac) and loxapine (Loxitane). High drug levels were associated with atrial flutter, indicating risks in overdose settings.

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Area of Science:

Pharmacology
Cardiology
Toxicology

Background:

Antidepressants like fluoxetine and antipsychotics like loxapine are commonly prescribed.
Overdose cases require understanding potential toxic effects on cardiac function.

Observation:

A 19-year-old male ingested a significant overdose of fluoxetine (600 mg) and loxapine (140 mg).
The patient experienced two episodes of atrial flutter following the overdose.

Findings:

Serum drug levels were elevated: fluoxetine 1,053 ng/mL, norfluoxetine 702 ng/mL, and loxapine 40 ng/mL.
The atrial flutter episodes were temporally associated with the drug overdose.

Implications:

This case suggests potential cardiotoxicity from fluoxetine and loxapine in overdose scenarios.
Understanding drug mechanisms is crucial for managing overdose patients and preventing cardiac complications.

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