A retrospective review of isolated duloxetine-exposure cases.
BACKGROUND
Duloxetine is a serotonin norepinephrine reuptake inhibitor (SNRI) approved in the US for the treatment of major depression, generalized anxiety, fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain. Given the limited published information regarding human overdoses to this medication, our goal was to characterize such exposures.


METHODS
We retrospectively reviewed a state poison system's database for all single agent exposures to duloxetine from 2004-2011. Data collected included age, gender, circumstances surrounding exposure, symptoms, and outcome. Patients with co-ingestants, confirmed non-exposure, unknown outcomes, or other coding errors were excluded.


RESULTS
159 cases were identified. 106 were included for review. Of 61 pediatric and adolescent cases (0-19 years old) identified, 53 involved unintentional overdose. Three patients experienced symptoms and none were admitted. All intentional ingestions(8) were seen in the emergency department, two patients experienced symptoms. No intentional ingestion was admitted for medical care. Fifty-one adult cases were included for review. Four adult patients were admitted following intentional duloxetine overdose with resolution of symptoms within 24 hours. Three adults were evaluated in a HCF following non-self-harm exposures to duloxetine. None of these patients were admitted. The remaining 15 adult patients with non-self-harm exposures were safely managed at home.


CONCLUSIONS
The majority of non-self-harm duloxetine-exposed adult and pediatric/adolescent patients were safely managed at home and when evaluated in a healthcare facility, did not require further hospitalization. Intentional pediatric/adolescent and adult duloxetine exposures were managed in a healthcare facility but rarely resulted in further hospitalization, serious morbidity, or mortality.
California Poison Control System, San Diego Division, San Diego, CA, USA. mdarracq@ucsd.edu
Michael A
MA
Darracq
Alycia
A
Clark
Lily
L
Qian
F Lee
FL
Cantrell
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000506:poisoning*; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D016208:Databases, Factual; D062787:Drug Overdose; D000068736:Duloxetine Hydrochloride; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers; D011247:Pregnancy; D012189:Retrospective Studies; D013406:Suicide, Attempted; D013876:Thiophenes / Q000506:poisoning*; D016896:Treatment Outcome; D055815:Young Adult
D018759:Adrenergic Uptake Inhibitors; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride