Overdose, particularly with ingestions of ER preparations Seizures may be delayed up to 16 hours following.Reveal dysphoria, anxiety, mydriasis, tremor, tachycardia and hypertension *Note these values do not apply to adolescents or adults (pleaseĭiscuss with toxicologist) Risk Assessment Children who have ingested doses greater than threshold for assessment (see below)ĭose requiring medical assessment in paediatric accidental ingestions:.All children with deliberate self-poisoning.Serotonin syndrome if other serotonergic agents are co-ingested.
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There is a risk of hypotension, prolonged QRS duration and QT interval, and cardiac dysrhythmias with large ingestions. Seizures may be delayed up to 16 hours following overdose, particularly following overdose with extended release preparations The risk of seizures following overdose with SNRIs is dose dependent.
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There is a high risk of serotonin syndrome if other serotonergic agents areĬo-ingested (NB Tramadol and tapentadol have weak SNRI effect).Symptoms usually begin within 4 hours of consumption, but may be delayed up to 16 hours (with ER preparations) and usually resolve within 24 hours.Less than 800 mg of venlafaxine are unlikely to cause significant toxicity Venlafaxine having the highest risk of toxicity in overdose:Īssociated with seizures and serotonergic toxidrome Venlafaxine are only available as extended-release (ER) preparationsįeatures are dose-dependent.
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Serotonin and Noradrenaline Re-uptake Inhibitors (SNRIs) include atomoxetine,ĭesvenlafaxine, duloxetine, reboxetine and venlafaxine.Serotonin syndrome should be managed in Paediatric ICUįor 24 hour advice, contact Victorian Poisons Information Centre 13 11 26 Background Children who have large ingestions or develop severe.Overdoses frequently causes seizures and in large ingestions can cause cardiovascular toxicity.Deliberate or accidental self-poisoning with Serotonin and Noradrenaline Re-uptake Inhibitors is potentially life-threatening.Hospital management of cardiopulmonary arrestĬare of the seriously unwell child Key points Poisoning – Acute guidelines for initial management