Observation and patient disposition after antipsychotic drug poisoning

Specific advice on observation and patient disposition after poisoning is given for the following antipsychotic drugs:

• amisulpride
• clozapine
• olanzapine
• quetiapine.

For all other antipsychotic drug poisonings, admit patients if they have significant sedation, QT-interval prolongation, respiratory depression or hypotension.

If a patient develops QT-interval prolongation following antipsychotic drug poisoning (particularly amisulpride, ziprasidone and haloperidol), observe them for at least 16 hours until the QT interval has normalised.

Discharge patients if their ECG is normal and they remain asymptomatic for at least:

• 6 hours after ingesting aripiprazole, asenapine, brexpiprazole, chlorpromazine, haloperidol, lurasidone, periciazine, risperidone or zuclopenthixol
• 12 hours after ingesting paliperidone or ziprasidone.

Sedative drugs can continue to cause significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge.