Coma Reversal After Intravenous Lipid Emulsion Therapy in a Trazodone-Poisoned Patient.
(2020) Clinical Neuropharmacology — Vol. 43, n° 1, p. 31-33 (2020)
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- A 77-year-old woman developed a deep coma (Glasgow Coma Scale score at 3/15) after a trazodone overdose (maximal ingested dose, 4500 mg), and orotracheal intubation was required for mechanical ventilation. In addition, she presented sinus bradycardia (<40/min) with QTc prolongation, whereas arterial blood pressure was preserved. The administration of intravenous lipid emulsion (1.5 mL/kg as a bolus followed by a continuous infusion of 0.5 mL/kg per minute for 30 minutes) resulted in a rapid improvement of her neurological condition, with a Glasgow Coma Scale score rising from 3 to 10/15 at the end of intravenous lipid emulsion infusion. A significant increase in heart rate (from 39 to 54/min) was also observed. The treatment was well tolerated, and the patient did not experience ventricular dysrhythmias. In addition, the patient was found to have a reduced metabolic activity related to cytochrome P450 2D6 polymorphism.
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Warnant, A., Gérard, L., Haufroid, V., & Hantson, P. (2020). Coma Reversal After Intravenous Lipid Emulsion Therapy in a Trazodone-Poisoned Patient. Clinical Neuropharmacology, 43(1), 31-33. https://doi.org/10.1097/WNF.0000000000000376 (Original work published 2020)