Specific substancesAntipsychotic drugs
Section snippets
Clinical features
- •
Extrapyramidal effects may occur even with therapeutic doses of antipsychotic drugs. These include acute dystonic reactions (more common in young individuals), parkinsonism (more common in the elderly) and tardive dyskinesia, which is not a feature of acute poisoning, and will diminish if an acute overdose is taken in a patient with this condition.
- •
Symptoms and signs more specifically related to overdose (Table 1) include CNS and respiratory depression, hypotension, cardiac arrhythmias (usually
Management
Following overdose a variety of presentations may be seen. Acute dystonic reactions respond to intravenous diazepam or to an anti-cholinergic agent (e.g. benztropine). Specific drug therapy is usually not indicated for parkinsonian features, which often improve on withdrawal of the offending agent. Therapy for overdose is supportive.
After correcting acidosis with sodium bicarbonate, the preferred treatment for arrhythmias caused by antipsychotic drugs (usually torsade de pointes) is intravenous
References (11)
- et al.
Upper airway compromise in acute chlorpromazine ingestion
Am J Emerg Med
(1996) - et al.
Acute pulmonary edema induced by overdosage of phenothiazines
Chest
(1992) - et al.
Sudden death and thioridazine
Br J Clin Pharmacol
(2001) - et al.
Electrocardiogram and cardiovascular changes in thioridazine and chlorpromazine poisoning
Eur J Clin Pharmacol
(2004) - et al.
Near fatal case of self-poisoning with thioridazine
Intens Care Med
(1996)
Cited by (3)
New dibenzothiepine sulfones synthesis and structure elucidation
2013, Revista de ChimieNovel dibenzothiepins with antibiofilm activity demonstrated by microbiological assays and molecular modeling
2013, Current Organic Chemistry