Cipram Overdosage

Citalopram is given to patients at potential risk of suicide and some reports of attempted suicide have been received. Detail is often lacking regarding precise dose or combination with other drugs and/or alcohol.
Symptoms: Experience from cases considered to be due to citalopram alone showed the following pattern. At doses below 600 mg, mild symptoms of nausea, dizziness, tachycardia, tremor, drowsiness and somnolence may occur. At doses above 600 mg, convulsions may occur within few hours after ingestion. ECG changes may occur and rarely rhabdomyolysis. Very few fatalities have been reported.
Treatment: There is no specific antidote. Treatment is symptomatic and supportive. Gastric lavage should be carried out as soon as possible after oral ingestion. ECG monitoring is recommended when more than 600 mg have been ingested. Convulsions may be treated with diazepam.
An adult patient has survived intoxication with 5,200 mg citalopram.
ECG monitoring is advisable in cases of overdose in patients with congestive heart failure/bradyarrhythmias, in patients using concomitant medications that prolong the QT interval, or in patients with altered metabolism e.g. liver impairment.