Assessment of Acute Antipsychotic Poisoned Cases Admitted to Tanta University Poison Control Unit

Abstract

Background: Sedative hypnotic/antipsychotic poisoning represented 5.84% of cases according to national poison data system in 2017. In Egypt, studies about antipsychotic poisoning are scarce. Objectives: is to assess the pattern of toxicity and prognosis of cases with acute antipsychotic poisoning admitted to Tanta University Poison Control Unit. Patients and Methods: This study was conducted on cases who admitted to Tanta University Poison Control Unit with acute antipsychotics poisoning. All cases were subjected to clinical evaluation, laboratory investigations and electrocardiogram. Severity was assessed by poison severity score. Results: Majority of cases were represented equally in age groups (0-10) and (11-20) years with 33.3% for each age group, 65% of cases were females, most of cases were from urban areas (71.7%) and singles (71.7%). History of mental disorder found in 31.6% of cases and suicidal attempts represented the most common manner of poisoning (71.7%). Clozapine was the highest antipsychotic drug taken (35%) and 6.7% of cases developed extrapyramidal manifestations. Miosis was found in 56.7% of cases. Tachycardia was recorded in 46.7% of cases and QTc interval was prolonged in 43% of cases. According to poison severity score, most studied cases were either mild (51.7%) or moderate (33.7%). One case was admitted to ICU. Multiple regression analysis showed that decreased GCS, PCO2, O2 saturation were associated with increased hospital stay. Conclusion: Antipsychotic poisoning was commonly mild to moderate. Neurological and cardiovascular manifestations were the predominant. Sinus tachycardia and prolonged QTc were the most common electrocardiographic changes. Antipsychotic poisoning usually had a good prognosis.

Characteristics of suicidal poisoned patients admitted to tertiary care center during COVID-19 pandemic

“…Compared to the accidental group in the current study, the suicidal poisoning group had a significant association with a history of psychiatric illness (19.4% versus 5.3%, p = 0.033) and therapeutic psychiatric drug administration (16.2% versus 2.6%, p = 0.027). These findings are harmonious with the results of previous researchers [ 34 , 35 ] who revealed that 13% and 31.6% of suicidal poisoned patients, respectively, had pre-existing psychiatric disorders. Nistor and colleagues [ 36 ] also concluded that psychological disturbance increases the risk of suicidal poisoning by 11% to 27% more than the overall population.…”

Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning

“…Despite it was a non-significant association, it is a clinically important finding that might be more pronounced in future research including a larger sample size. Supporting evidence has been reported by Mubarak et al 4 who found a significant association between GCS and the duration of hospital stay. Moreover, they demonstrated a low GCS as a predictor of the prolonged hospital stay.…”

“…6,28,33,34 Moreover, a high frequency of prolonged QTc interval in atypical antipsychotics poisoning has been observed in a recent prospective analysis of patients admitted with acute antipsychotics poisoning. 4 Prolongation of QTc interval is a life-threatening complication of various atypical antipsychotics overdose. It may induce lethal arrhythmia including torsade de pointes and ventricular fibrillation.…”

“…3 In Egypt, recent studies from Tanta University Poison Control Centre (TUPCC) and the National Poisoning Center, Cairo have explored acute clozapine poisoning as a frequent category among central nervous system pharmaceutical drug poisonings. 4,5…”

Impact of COVID-19 lockdown on acute pediatric antipsychotic poisoning outcome in Tanta University Poison Control Centre

“…rug ingestion is the commonest cause of acute poisoning among children according to poison control centers records all over the world. A great percent of hospital admission cases involves drug poisoning, particularly with psychotropic drugs such as sedatives, antidepressants, and neuroleptics (Watson et al, 2004;Gummin et al, 2017;Mubarak et al, 2019).…”