Overdose

Experience
Clinical data on escitalopram overdose are limited and many cases involve concomitant overdoses of other drugs. In the majority of cases, mild or no symptoms have been reported. Doses between 400 and 800 mg of escitalopram alone have been taken without any severe symptoms (Escitalopram SPC, 2007). Experience from 28 cases of isolated (accidental or intentional) escitalopram exposure (5–300 mg), identified at a US poison centre (LoVecchio et al., 2006), indicated no adverse sequelae.

Symptoms
Symptoms seen in reported overdose of escitalopram related mainly to the central nervous system (ranging from dizziness,
tremor, and agitation to rare cases of convulsion and coma), the gastrointestinal system (nausea/vomiting), and the cardiovascular system (hypotension and electrolyte/fluid balance conditions [hypokalaemia, hyponatraemia]) (Escitalopram SPC, 2007).

Treatment
There is no specific antidote. Establish and maintain an airway, ensure adequate oxygenation and respiratory function. Gastric lavage and the use of activated charcoal should be considered. Gastric lavage should be carried out as soon as possible after oral ingestion. Cardiac and vital signs monitoring are recommended, along with general symptomatic supportive measures (Escitalopram SPC, 2007).

 

References:

LoVecchio et al. J Emerg Med. 2006; 30(1):17-9

Escitalopram SPC, 2007