West J Emerg Med. This article has been cited by other articles in PMC, fluoxetine 500mg. Abstract A year-old woman experienced a witnessed generalized seizure in the Emergency Department three hours after ingesting approximately mg of fluoxetine in a suicide attempt. Although the majority of fluoxetine ingestions are benign, fluoxetine may occur after large intentional overdoses.
The majority of fluoxetine overdoses result in a benign clinical course. We report the case of a witnessed, fluoxetine 500mg, generalized fluoxetine occurring three hours after a fluoxetine overdose in an otherwise healthy young woman.
CASE REPORT A year-old woman with a history of bulimia nervosa and depression ingested approximately seventy 20 mg fluoxetine capsules 500mg 4—5 cans of beer in a self-professed suicide attempt, fluoxetine 500mg.
Shortly fluoxetine, she telephoned a friend who activated the EMS system. The patient stated that she had taken her buspirone only as directed, fluoxetine 500mg, with the last dose fluoxetine the morning of the 500mg overdose, about six hours earlier. She specifically fluoxetine ingesting any additional buspirone or any other medications, fluoxetine 500mg. Other than some orthopedic surgical procedures, she denied any other significant past medical history, including seizures.
The paramedics arrived approximately 90 minutes post-ingestion and found the patient to be awake, fluoxetine 500mg, alert, sitting up, and emotionally upset, fluoxetine 500mg. In the emergency department ED her vital signs were: The emergency physician 500mg the patient to be alert and oriented, but with slurred speech and slow verbal 500mg time. The patient had a non-focal neurologic exam without tremor, rigidity, or hyperreflexia, and the remainder of the physical examination 500mg without noted abnormalities.
The patient was given 50 g of activated charcoal, fluoxetine blood and urine samples were obtained for baseline values and for quantitative serum acetaminophen and salicylate measurements. A qualitative urine pregnancy test was negative. An electrocardiogram revealed a normal sinus rhythm of 97 beats per minute with normal intervals QRS 88 500mg, QTc msec.
Approximately three hours after the ingestion, the patient cried out and then experienced a generalized tonic-clonic seizure lasting 30 seconds witnessed by the ED personnel. The seizure resolved spontaneously, fluoxetine 500mg, and the fluoxetine had a post-ictal period lasting five minutes. On arrival to the intensive care unit, the patient was somnolent but easily 500mg.
A repeat physical examination was unremarkable including the neurologic exam. The laboratory fluoxetine that buspirone can be detected by this analysis.
Quantitative fluoxetine levels of fluoxetine, norfluoxetine, and buspirone were ordered on admission. The quantitative buspirone level could not be determined due to laboratory handling error. The patient was observed overnight without any further seizure activity or other unusual events.
The psychiatry consultation and liaison service evaluated the patient the following morning and arranged for outpatient therapy. The patient was then discharged home in stable condition. The seizure does not appear to be related to serotonin syndrome, because the patient did not exhibit autonomic instability, muscular rigidity, fluoxetine 500mg, or abnormal micardis 80mg cheap status excluding the seizure itself and 500mg brief post-ictal period as typically occur in that disorder.
Firstly, she was only an occasional ethanol consumer without a history of dependence or prior episodes of withdrawal; in such a case, the presence of ethanol would, if anything, fluoxetine 500mg, act as an fluoxetine. Secondly, she did not exhibit signs of 500mg instability e. She was initially tachycardic, but this is 500mg commonly found in cases of significant SSRI overdose.
A seizure has been reported in a patient receiving therapeutic doses of 500mg and buspirone for obsessive-compulsive disorder, fluoxetine 500mg. When questioned about this finding, fluoxetine 500mg, she reported that she fluoxetine caffeine-containing beverages e. Although a serum 500mg level is not available for this patient, she was not exhibiting symptoms of caffeine intoxication such as tremor, agitation, hyperglycemia or hypokalemia.
In order for caffeine to be responsible for 500mg seizure, one would expect the patient to exhibit prominent symptoms of caffeine fluoxetine. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant fluoxetine intentional, high-dose fluoxetine ingestions may induce seizures, fluoxetine 500mg.
Footnotes Reprints available through open access at www. Fluoxetine J Emerg Medicine. Seizure activity associated with fluoxetine therapy. Seizures associated with fluoxetine therapy. Braitberg G, Curry SC. Seizure after isolated fluoxetine overdose. Generalized seizures caused by fluoxetine overdose.
Fluoxetine-induced cardiotoxicity with response to bicarbonate therapy. The pharmacologic profile of fluoxetine. The safety of fluoxetine - an update. The serotonergic and fluoxetine effects of antidepressant drugs are anticonvulsant, not 500mg.
Antidepressant drugs and seizure susceptibility: Relative toxicity of selective serotonin reuptake inhibitors SSRIs in overdose, fluoxetine 500mg. Dose-dependent seizure activity associated with fluoxetine therapy. Seizure associated with fluoxetine and adjuvant buspirone therapy.
Buspirone augmentation of fluoxetine in obsessive-compulsive disorder. Presentation and management of an acute caffeine overdose.
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