Fluoxetine ingestion: a one year retrospective study.
Fluoxetine (PROZAC) is a recently marketed straight chain antidepressant unrelated to the cyclic anti-depressants. There is only limited information on fluoxetine and a single case report on overdose (benign outcome) in the literature. In response to this we performed a 1y retrospective chart review at 2 AAPCC certified poison centers. Forty-four exposures to fluoxetine were reviewed from 1988; 31 cases were treated in a HCF, 2 cases were followed at home by phone and 11 cases were lost to follow up. Thirteen cases with follow up (FU) reported no coingestants; 3 cases reported increased anxiety without cardiovascular (CV) changes, 2 cases presented confused with out CV changes, and 8 cases were asymptomatic. Eight cases with FU had ETOH and/or benzodiazepines as a coingestant and experienced only a decreased level of consciousness that could be explained by the coingestant. Five cases remained asymptomatic with reported coingestants of APAP #3, lorazepam, haloperidol, molindone, alprazolam, propranolol, phenobarbital (level 18.2). Four cases were excluded from the evaluation due to the coingestants involved. No seizures were recorded in this series. Three possible drug reactions occurred; 2 cases had reactions with tranylcypromine (PARNATE), and 1 case with a diagnosis of septicemia had a severe hyperthermic reaction with therapeutic coingestants of mephytoin, verapamil, digoxin and indocin. We believe overdose with fluoxetine present minimal risk of serious cardiovascular or neurological complications.
Spiller
H A
HA
Deleware Valley Regional Poison Control Center, Philadelphia, PA 19104.
Morse
S
S
Muir
C
C
D000059:Accidents; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004347:Drug Interactions; D004781:Environmental Exposure; D005473:Fluoxetine / Q000009:adverse effects / Q000506:poisoning*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012189:Retrospective Studies; D013406:Suicide, Attempted; D013997:Time Factors; D014191:Tranylcypromine / Q000627:therapeutic use
D005473:Fluoxetine; D014191:Tranylcypromine