title: Serum fluoxetine and norfluoxetine levels support the safety of fluoxetine in overdose.
abstract: BACKGROUND
  Previous literature has found fluoxetine to be relatively safe in overdose. This study hopes to examine this idea along with support from published pharmacokinetic information including serum fluoxetine and norfluoxetine levels based on information from a clinical case series.
  
  
  METHODS
  Four cases are presented along with vital abnormalities, electrocardiogram abnormalities, and physical exam abnormalities along with amount of overdose and resulting serum fluoxetine and norfluoxetine levels.
  
  
  METHODS
  In these four cases, serum fluoxetine and norfluoxetine days after overdose were found to be in a range believed to be within the treatment range. No abnormalities were found on electrocardiogram but some patients (3) were found to have slight elevations in heart rate.
  
  
  CONCLUSIONS
  Fluoxetine is relatively safe in overdose. This study supports previous literature. Future directives for research can be directed towards when serotonergic, including fluoxetine, medications can be introduced or restarted in patients who have overdosed. Research could also focus on if the introduction of another medication, such as carbamazepine, to induce metabolism of a medication, such as fluoxetine, after an overdose.
authors.affiliation: Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospitals Cleveland Medical Center, 10524 Euclid Ave, WO Walker Building, First Floor, Cleveland, OH USA.
authors.forename: Stephanie
authors.identifier: 0000-0003-1948-9398
authors.initials: S
authors.lastname: Pope
authors.affiliation: Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospitals Cleveland Medical Center, 10524 Euclid Ave, WO Walker Building, First Floor, Cleveland, OH USA.
authors.forename: Solomon G
authors.initials: SG
authors.lastname: Zaraa