Antidepressant overdose: symptoms and treatment

Abstract

In recent years, an increased use of antidepressant medications has resulted in a heightened incidence of drug overdose. Because of this increased use, more types of antidepressant agents have become available. Therefore, emergency-room physicians not only have to recognize the overdose patient (often unwilling or unable to communicate with the physician), but also, identify the overdose agents if possible, and initiate early and appropriate treatment. Recognizing overdose signs and symptoms associated with various antidepressant agents is essential in choosing the appropriate treatment. Tricyclic agent overdoses account for most of the hospital admissions and deaths due to antidepressant therapy; a majority of these deaths are attributable to cardiac complications. In contrast, trazodone, one of the safest drugs when taken in overdose, is not associated with cardiac arrhythmias. Thus, trazodone-overdose patients generally require only emesis and/or gastric lavage, and minimal supportive therapy, whereas tricyclic antidepressant overdoses often require more aggressive intervention.