Circulation

Treatment for hypotension

For hypotension due to amisulpride poisoning, first-line treatment is intravenous fluid resuscitation. If hypotension persists, start inotropic support with adrenaline (epinephrine) (rather than noradrenaline [norepinephrine]), as patients are often bradycardic.

Treatment for arrhythmias

For patients who ingested less than 4 g of amisulpride, perform serial 12-lead ECGs for at least 16 hours to assess for cardiotoxicity.

For patients who ingested 4 g or more of amisulpride, commence continuous ECG monitoring and assess serial 12-lead ECGs to detect QT-interval prolongation and torsades de pointes. Continue ECG monitoring for at least 16 hours. If there is evidence of QT-interval prolongation on ECG or torsades de pointes develops, manage urgently according to Treatment for QT-interval prolongation and torsades de pointes.

For cardiorespiratory arrest and life-threatening arrhythmias, follow advanced life support protocols and seek advice from a clinical toxicologist¹.