Trazodone toxicity: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*CNS depression | *[[CNS Depression|CNS depression]] | ||
**Most common symptom | **Most common symptom | ||
**Rarely produces coma or seizures when it is the only drug ingested | **Rarely produces [[coma]] or [[seizures]] when it is the only drug ingested | ||
*Respiratory | *[[Respiratory distress|Respiratory depression]] | ||
**Fairly common (but only with coingestants) | **Fairly common (but only with coingestants) | ||
*Orthostatic hypotension | *Orthostatic [[hypotension]] | ||
*QT prolongation | *[[QT prolongation]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Sedatve/hypnotic toxicity types}} | |||
==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis, assess for alternate etiologies | |||
==Management== | ==Management== | ||
Latest revision as of 01:23, 14 September 2019
Background
- Trazodone is extremely safe in overdose as long as there are no coingestants
- Has serotonergic and α blocking effects
Clinical Features
- CNS depression
- Respiratory depression
- Fairly common (but only with coingestants)
- Orthostatic hypotension
- QT prolongation
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Evaluation
- Clinical diagnosis, assess for alternate etiologies
Management
- Supportive care
- Activated charcoal and gastric lavage are not indicated
- QT prolongation
- Treat torsades in usual manner
- Hypotension
- IVF
- Norepinephrine
- Dopamine is contraindicated
Disposition
- Consider discharge for patients who remain asymptomatic for at least 6 hours