Amisulpride Overdose Is Frequently Associated With QT Prolongation and Torsades de Pointes

@article{Isbister2010AmisulprideOI,
  title={Amisulpride Overdose Is Frequently Associated With QT Prolongation and Torsades de Pointes},
  author={Geoffrey K. Isbister and Corrine R. Balit and Dawson Macleod and Stephen B. Duffull},
  journal={Journal of Clinical Psychopharmacology},
  year={2010},
  volume={30},
  pages={391-395}
}
This study aimed to describe the effects of the antipsychotic amisulpride in overdose, including the frequency of QT prolongation and torsades de pointes. Cases of amisulpride overdose (>1 g) were recruited from 2 state poison centers and a tertiary toxicology unit over 5 years. A 1-page clinical research form was used to collect clinical information. Copies of all electrocardiograms were obtained. Electrocardiogram parameters (QRS and QT intervals) were manually measured as previously… 
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References

SHOWING 1-10 OF 29 REFERENCES
Citalopram overdose: Late presentation of torsades de pointes (TdP) with cardiac arrest
TLDR
A 36-year-old woman complained of shakiness, numbness in the arms, and palpitations that began approximately 32 hours after ingesting 50 (20-mg) tablets of citalopram, and her corrected QT interval remained abnormal for 24 hours after presentation.
Activated charcoal decreases the risk of QT prolongation after citalopram overdose.
Quetiapine overdose: predicting intubation, duration of ventilation, cardiac monitoring and the effect of activated charcoal
TLDR
Ingested dose can inform early decision making about requirements for intensive care unit admission and intubation and SDAC seems to have only modest effects on outcomes but may be considered within 2 h for large ingestions.
Drug-induced QT prolongation and torsades de pointes: evaluation of a QT nomogram.
TLDR
The QT nomogram is a clinically relevant risk assessment tool that accurately predicts arrhythmogenic risk for drug-induced QT prolongation from QT-RR combinations.
Fatality due to amisulpride toxicity
TLDR
A case of fatal amisulpride toxicity is reported where the post-mortem blood concentration was 48 mg/L, and a knowledge of the ability of antipsychotic agents to induce fatal cardiac arrhythmias should inform the approach to the autopsy.
Cardiotoxicity more common in thioridazine overdose than with other neuroleptics.
TLDR
The aim of this study was to examine the clinical and electrocardiographic features associated with neuroleptic poisoning and compare thioridazine with other neuroleptics and found no significant differences in the odds ratios observed.
Amisulpride deliberate self‐poisoning causing severe cardiac toxicity including QT prolongation and torsades de pointes
TLDR
Electrocardiogram assessment until at least 16 h after amisulpride overdose and, if QT interval is prolonged, cardiac monitoring until the patient is clinically well and conduction intervals are normal.
Safety of amisulpride (Solian): a review of 11 clinical studies.
TLDR
The overall laboratory safety profile of amisulpride did not show clinically relevant abnormalities in liver function tests nor haematological abnormalities, and was superior to standard reference compounds.
Olanzapine overdose: a series of analytically confirmed cases
TLDR
There was no relationship between the dose and length of hospital stay, intensive care unit admission, Glasgow coma score <9 or delirium, but there was a trend towards more severe outcomes in patients not taking olanzapine therapeutically.
Torsade de pointes associated with Astemizole overdose treated with magnesium sulfate.
TLDR
The case of a 14-year-old female who intentionally ingested 270 mg of Astemizole and developed torsade de pointes, a form of polymorphic ventricular tachycardia that is associated with prolongation of the QTc interval is reported.
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