Rhabdomyolysis Complicating Doxylamine Overdose

Lee, So Young; Kang, Young Sun; Han, Sang Youp; Yoon, Jong Woo; Jo, Sang Kyung; Cha, Dae Ryong; Cho, Won Yong; Kim, Hyoung Kyu

Abstract

BACKGROUND: Because of its ready availability in over-the-counter sleep preparations, doxylamine succinate is used frequently for suicidal attempts. Non-traumatic rhabdomyolysis is known to be a rare complication of doxylamine succinate but its pathogenesis and dose dependent effect are not known. The purpose of this study is to examine the frequency of various complications, especially rhabdomyolysis in doxylamine overdose and also to examine the effect of dose on the occurrence of these complications.
METHODS
Medical records of patients who ingested doxylamine succinate from July 1996 to June 2000 were reviewed. Their age, sex, amount of ingestion and laborotory data are collected and also the occurrence of complication and dose-complication relationship were examined.
RESULTS
1) Total number of patients was 33 and average dose of ingestion was 1,510.6+/-180.7mg(150-5,000). 2) Complication rates were as follows tachycardia 20 patients(66%), hypertension 17 patients(51%), rhabdomyolysis 16 patients(48.4%), generalized seizure 7 patients(21.2%) and hyperthermia 5 patients(15.1%). 3) Tachycardia, seizure and rhabdomyolysis were occured more frequently in high dose groups.
CONCLUSION
Rhbdomyolysis is not an infrequent complication in doxylamine overdose. Recognition of potential hazard for rhabdomyolysis and the institution of vigorous treatment to prevent acute renal failure, especially in patients who have taken a large amount of drugs will be required.