Amisulpride deliberate self-poisoning causing severe cardiac toxicity including QT prolongation and torsades de pointes.
Although clinical trials of the antipsychotic amisulpride revealed no cardiac adverse effects, four patients with severe cardiac toxicity after overdose were reported to Australian poisons information centres in 2004-2005. All four had QT prolongation over 500 ms, two had rate-dependent bundle branch block, two developed torsades de pointes, and one died after cardiac arrest. Pending further studies, we recommend electrocardiogram assessment until at least 16 h after amisulpride overdose and, if QT interval is prolonged, cardiac monitoring until the patient is clinically well and conduction intervals are normal.
Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, NT. gsbite@ferntree.com
Geoffrey K
GK
Isbister
Lindsay
L
Murray
Sally
S
John
L Peter
LP
Hackett
Tedo
T
Haider
Phebe
P
O'Mullane
Sophie
S
Gosselin
Frank
F
Daly
D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000097:blood / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D062787:Drug Overdose; D004562:Electrocardiography; D004635:Emergency Medicine / Q000379:methods; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D013405:Suicide; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000097:blood / Q000506:poisoning; D016171:Torsades de Pointes / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D013469:Sulpiride; D000077582:Amisulpride