Management overview for SSRI poisoning
Selective serotonin reuptake inhibitors (SSRIs) include citalopram, dapoxetine1, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. Vortioxetine increases serotonin activity in the central nervous system (CNS) and has similar effects to SSRI drugs.
Poisoning due to SSRIs usually causes mild toxicity, and recovery is expected with supportive care. Serotonergic toxidrome can occur, but is usually only severe if the SSRI has been co-ingested with another serotonergic drug or following massive ingestions of a single SSRI drug. Cardiovascular toxicity is uncommon, although citalopram and escitalopram cause dose-dependent QT-interval prolongation and torsades de pointes.
Management of SSRI poisoning is supportive, and aims to urgently identify and address serotonergic toxidrome and cardiovascular toxicity if present.