ABSTRACT
BACKGROUND: Ziprasidone is an atypical antipsychotic associated with QTc prolongation during therapeutic use. We characterized the clinical manifestations associated with ziprasidone overdoses, in particular the incidence and severity of QTc prolongation. METHODS: Four regional poison centers prospectively collected ziprasidone overdose data from August 1, 2003 to October 1, 2005. Cases were included if they were followed to known medical outcome and comprised single-substance ziprasidone exposures or with co-ingestants not associated with prolongation of the QTc interval. RESULTS: Fifty-six ziprasidone exposures met inclusion criteria. The most common clinical effects were drowsiness (N=38, 67.9%) and tachycardia (N=19, 33.9%). QTc prolongation (>0.500 second) occurred in only one patient. Seven patients had QTc intervals of 0.450 to 0.500 second. Medical outcomes were coded as no effect (13, 23.2%), minor effect (21, 35.5%), moderate effect (20, 35.7%), or major effect (2, 3.4%). CONCLUSION: Common clinical effects following ziprasidone overdose are drowsiness and tachycardia. Clinically significant QTc prolongation occurs infrequently.
Subject(s)
Antipsychotic Agents/poisoning , Piperazines/poisoning , Poison Control Centers , Thiazoles/poisoning , Adolescent , Adult , Aged , Drug Overdose , Female , Humans , Long QT Syndrome/chemically induced , Long QT Syndrome/physiopathology , Male , Middle Aged , Prospective Studies , Sleep Stages , Tachycardia/chemically induced , Tachycardia/physiopathologyABSTRACT
BACKGROUND: Aripiprazole is a new psychotropic agent that possesses a unique pharmacologic profile. The drug demonstrates mixed dopamine and serotonin agonist-antagonist activity and has been labeled a third-generation antipsychotic and dopamine-serotonin system stabilizer. Overdose experience is limited, especially in pediatrics. CASE SERIES: Of five pediatric cases identified, toxicity was mainly evident in younger patients. A 2-year-old who ingested 40 mg experienced vomiting and significant lethargy lasting approximately 30 h. A 6-year-old who received two doses of aripiprazole therapeutically experienced lethargy, drooling, and flaccid facial muscles which improved with diphenhydramine. Two adolescents remained asymptomatic despite doses of 120 mg and 300 mg while a third adolescent with an unknown dose experienced transient lethargy. CONCLUSION: Aripiprazole is capable of producing marked lethargy and gastrointestinal upset in pediatric patients. Adolescents in this series experienced only minor, if any, clinical effects. Major clinical effects, i.e., seizures, dysrhythmias, were not reported in this series.
Subject(s)
Antipsychotic Agents/poisoning , Drug Overdose/therapy , Pediatrics , Piperazines/poisoning , Quinolones/poisoning , Adolescent , Aripiprazole , Child , Child, Preschool , Drug Overdose/pathology , Drug Overdose/physiopathology , Female , Humans , Male , Poison Control Centers , Suicide, Attempted , Treatment OutcomeABSTRACT
BACKGROUND: Lamotrigine is an antiepileptic drug for the treatment of partial and generalized seizures as well as bipolar disorder. Limited published information exists describing the clinical effects of lamotrigine overdose. OBJECTIVE: To examine the toxicity of exposures to lamotrigine utilizing national poison center data. METHODS: Data on single-substance exposures to lamotrigine reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System in 2000 and 2001 were retrospectively analyzed. RESULTS: There were 493 cases that met the inclusion criteria. The majority of exposures occurred within the age groups 20-59 years old (n = 198, 40.2%), followed by
