| Title |
Overdose of Atypical Antipsychotics
|
|---|---|
| Published in |
CNS Drugs, December 2012
|
| DOI | 10.2165/11631640-000000000-00000 |
| Pubmed ID | |
| Authors |
Michael Levine, Anne-Michelle Ruha |
| Abstract |
Historically, treatment for schizophrenia focused on sedation. The advent of the typical antipsychotics resulted in treatment aimed specifically at the underlying disease, but these agents were associated with numerous adverse effects, and were not particularly effective at treatment of the negative symptoms of schizophrenia. As a result, numerous atypical agents have been developed over the past 2 decades, including several agents within the past 5 years. Overdose of antipsychotics remains quite common in Western society. In 2010, poison control centres in the US received nearly 43,000 calls related to atypical antipsychotics alone. Due to underreporting, the true incidence of overdose with atypical antipsychotics is likely much greater. Following overdose of an atypical antipsychotic, the clinical effects observed, such as CNS depression, tachycardia and orthostasis are largely predictable based on the unique receptor binding profile of the agent. This article, which focuses on the atypical antipsychotics commonly used in the treatment of schizophrenia, discusses the features commonly encountered in overdose. Specifically, agents that result in QT prolongation and the corresponding potential for torsades de pointes, as well as unique features encountered with the various medications are discussed. The diagnosis of this overdose is largely based on history. Routine use of drug screens is unlikely to be beneficial. The primary goal of management is aggressive supportive care. Patients with significant CNS depression with associated loss of airway reflexes and respiratory failure need advanced airway management. Hypotension should be treated first with intravenous fluids, with the use of direct acting vasopressors reserved for persistent hypotension. Benzodiazepines should be used for seizures, with barbiturates used for refractory seizures. Intravenous magnesium can be administered for patients with a corrected QT interval exceeding 500 milliseconds. |
Mendeley readers
The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 2% |
| Unknown | 63 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 11 | 17% |
| Researcher | 7 | 11% |
| Student > Doctoral Student | 5 | 8% |
| Student > Ph. D. Student | 4 | 6% |
| Student > Postgraduate | 4 | 6% |
| Other | 14 | 22% |
| Unknown | 19 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 39% |
| Psychology | 6 | 9% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 6% |
| Nursing and Health Professions | 2 | 3% |
| Agricultural and Biological Sciences | 2 | 3% |
| Other | 3 | 5% |
| Unknown | 22 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 February 2021.
All research outputs
#2,112,650
of 25,654,806 outputs
Outputs from CNS Drugs
#153
of 1,397 outputs
Outputs of similar age
#19,327
of 290,040 outputs
Outputs of similar age from CNS Drugs
#3
of 67 outputs
Altmetric has tracked 25,654,806 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,397 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.7. This one has done well, scoring higher than 88% of its peers.
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We're also able to compare this research output to 67 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.