Decontamination
Gastrointestinal decontamination with activated charcoal is rarely required after SSRI poisoning.
For SSRI ingestions of more than 50 times the ‘defined daily dose’1, offer activated charcoal to alert and cooperative patients who are able to protect their airway and present within 2 hours after the estimated ingestion time.
Based on pharmacokinetic-pharmacodynamic studies, activated charcoal is also recommended for ingestions of more than 600 mg of citalopram or 300 mg of escitalopram if the patient is alert and cooperative, able to protect their airway and presents within 4 hours after the estimated ingestion time.
If the patient is intubated, activated charcoal can be given any time after ingestion via a nasogastric or orogastric tube—confirm correct placement of the nasogastric or orogastric tube beforehand.