Korean J Psychopharmacol.  2008 Dec;19(6):323-333.

Characteristics of Cardiac Toxicity in Antidepressant Overdose and Its Treatment

• Choi KH
• Lee KU

Abstract

The mortality and morbidity in tricyclic antidepressants (TCAs) overdose still remained high due to fatal cardiac toxicities despite their decreased prescriptions. Also, monoamine oxidase inhibitors (MAOIs) may show relatively high cardiac toxicities in excess or mixed overdoses. Selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants have been known to be safe in overdose until recently. However, many researchers have found that SSRIs and newer antidepressants also showed serious and fatal toxicities in case of excess or mixed overdoses. Citalopram or escitalopram overdoses showed a relatively high incidence of cardiac toxicity with a dose-dependent manner. Also, venlafaxine, bupropion and trazodone overdoses showed significant cardiac toxicities, although degrees of the toxicities are different each other. Especially, venlafaxine's pattern and incidence of cardiac toxicities are the similar to those of TCAs. Mirtazapine and reboxetine show no significant toxicities in overdose although the present toxicological data are insufficient. To conclude, assessment of compliance, pharmacology education for patients and effective treatment may reduce the incidence and severity of toxicities in overdose.

Keyword

Antidepressants; Overdose; Cardiac Toxicity

MeSH Terms

Antidepressive Agents
Antidepressive Agents, Tricyclic
Bupropion
Citalopram
Compliance
Cyclohexanols
Humans
Incidence
Mianserin
Monoamine Oxidase Inhibitors
Morpholines
Prescriptions
Serotonin Uptake Inhibitors
Trazodone
Venlafaxine Hydrochloride
Antidepressive Agents
Antidepressive Agents, Tricyclic
Bupropion
Citalopram
Cyclohexanols
Mianserin
Monoamine Oxidase Inhibitors
Morpholines
Serotonin Uptake Inhibitors
Trazodone