An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System.
Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration-approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient's progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects.
Touro University, Vallejo, CA, USA shadi.doroudgar@gmail.com.
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S
Doroudgar
Clinical Sciences Department, Touro University, Vallejo, CA, USA.
P J
PJ
Perry
California Northstate University College of Medicine, Elk Grove, CA, USA.
G D
GD
Lackey
Touro University, Vallejo, CA, USA.
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NG
Veselova
Touro University, Vallejo, CA, USA.
H M
HM
Chuang
Division of Pulmonary and Critical Care Medicine, UC Davis Medical Center, Sacramento, CA, USA Northern California VA Medical System, Mather, CA, USA.
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TE
Albertson
D000293:Adolescent; D002140:California; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D056687:Off-Label Use / Q000706:statistics & numerical data; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity*; D000069470:Venlafaxine Hydrochloride / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity*; D055815:Young Adult
D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride
Venlafaxine; children; human; poisoning; toxicology