J Korean Soc Clin Toxicol.  2016 Dec;14(2):100-106. 10.22537/jksct.2016.14.2.100.

The Intoxication of Beta Blocker with Psychiatric Drugs Focused on the Cardiovascular Adverse Effects

• Joo SW
• Min YG
• Choi SC
• Park EJ

• KMID: 2368184
• DOI: http://doi.org/10.22537/jksct.2016.14.2.100

Abstract

PURPOSE
Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system.
METHODS
A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled.
RESULTS
Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis.
CONCLUSION
Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

Keyword

Beta-adrenergic blocker; Psychiatry; Cardiovascular system; Adverse effects

MeSH Terms

Anxiety
Arterial Pressure
Cardiovascular System
Emergency Service, Hospital
Humans
Hypotension
Logistic Models
Panic Disorder
Propranolol
Quetiapine Fumarate
Retrospective Studies
Propranolol
Quetiapine Fumarate