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Review
. 2025 Aug 31;14(17):6160.
doi: 10.3390/jcm14176160.

A Narrative Review on Toxidromes in the Psychiatric Population: Implications for Overdose Prevention

Sanjukta Dutta  1 , Adela Georgiana Buciuc  2 , Patrick Barry  2 , Vanessa Padilla  1
Affiliations
Review

A Narrative Review on Toxidromes in the Psychiatric Population: Implications for Overdose Prevention

Sanjukta Dutta et al. J Clin Med. .

Abstract

Individuals with severe mental illness face a substantially higher risk of suicide compared with the general population, with drug overdose representing one of the most common and potentially lethal methods. This narrative review explores toxidromes frequently encountered in psychiatric populations, such as opioid, anticholinergic, and serotonergic toxicity, highlighting the clinical presentation in intentional overdose. Emphasis is placed on clinical recognition, antidote-based treatment, and systems-level strategies for the prevention of lethal overdose. We conducted a comprehensive literature search of PubMed, Google Scholar, and Web of Science for English-language articles using combinations of the following keywords: mental disorders; persons with psychiatric disorders; drug overdose; poisoning; serotonin syndrome; neuroleptic malignant syndrome; anticholinergic agents/poisoning; cholinergic antagonists/poisoning; psychotropic drugs/adverse effects; substance-related disorders; drug-related side effects and adverse reactions; polypharmacy; suicide, attempted; emergency service, hospital. By embedding toxidrome awareness into routine emergency and psychiatric practice, we aim to expedite treatment and improve patient outcomes.

Keywords: anticholinergic poisoning; drug overdose; mental illness; neuroleptic malignant syndrome; poisoning; psychiatry; psychotropic drugs; public health; serotonin syndrome; suicide.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Clinical approach to suspected overdose.
See this image and copyright information in PMC

References

    1. U.S. Department of Homeland Security . Report on the Toxic Chemical Syndrome. U.S. Department of Homeland Security; Washington, DC, USA: 2012.
    1. Abesamis M.G. Toxidromes. In: Ackerman K.D., Dimartini A.F., editors. Psychosomatic Medicine. Oxford University Press; Oxford, UK: 2015. pp. 295–314.
    1. Rasimas J.J., Sinclair C.M. Assessment and Management of Toxidromes in the Critical Care Unit. Crit. Care Clin. 2017;33:521–541. doi: 10.1016/j.ccc.2017.03.002. - DOI - PubMed
    1. Greene S., AufderHeide E., French-Rosas L. Toxicologic Emergencies in Patients with Mental Illness. Psychiatr. Clin. N. Am. 2017;40:519–532. doi: 10.1016/j.psc.2017.05.007. - DOI - PubMed
    1. Lavonas E.J., Akpunonu P.D., Arens A.M., Babu K.M., Cao D., Hoffman R.S., Hoyte C.O., Mazer-Amirshahi M.E., Stolbach A., St-Onge M., et al. 2023 American Heart Association Focused Update on the Management of Patients with Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023;148:e149–e184. doi: 10.1161/cir.0000000000001161. - DOI - PubMed

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