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Non-fatal mirtazapine overdose

W Retz1, S Maier, F Maris

  • 1Department of Psychiatry, University of Würzburg, Germany. psychpol@mail.uni-wuerzberg.de

International Clinical Psychopharmacology
|December 23, 1998
PubMed
Summary

Severe hypothermia and mirtazapine intoxication occurred in a major depression patient after a 1200 mg overdose. The patient experienced dangerously low body temperature and rhabdomyolysis but recovered fully.

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Area of Science:

  • Clinical Toxicology
  • Pharmacology
  • Emergency Medicine

Background:

  • Mirtazapine is an antidepressant medication.
  • Major depression is a common psychiatric disorder.
  • Hypothermia can be life-threatening.

Observation:

  • A 41-year-old female with major depression overdosed on 1200 mg mirtazapine and 20 mg lorazepam.
  • The patient was exposed to sub-zero outdoor temperatures for 10 hours.
  • Severe hypothermia (body temperature 26°C) and rhabdomyolysis were observed.

Findings:

  • Mirtazapine plasma levels remained high (368 ng/ml) after 41 hours.
  • Cardial and respiratory functions were compromised, necessitating intubation.
  • The patient recovered without long-term physical impairment.

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Implications:

  • This case highlights the risk of severe hypothermia in antidepressant overdose combined with environmental exposure.
  • Sustained high mirtazapine levels indicate a long elimination half-life.
  • Prompt intensive care is crucial for managing such complex overdose cases.