In acute psychotropic drug poisoning, it is important to diagnose and treat complications, including aspiration pneumonitis, abnormal body temperature, and atraumatic crush syndrome/compartment syndrome (3As). For the gastrointestinal decontamination (GID) of psychotropic drugs, excluding lithium, the administration of activated charcoal through a naso-gastric tube should be considered first. For the GID of sustained-release or enteric-coated psychotropic drugs, total bowel irrigation is an option. To eliminate phenobarbital and carbamazepine, multiple doses of activated charcoal or direct hemoperfusion should be considered. To eliminate lithium, hemodialysis is an option. As an antidote to tricyclic antidepressants, the intravenous administration of sodium bicarbonate may be effective.
<Author's abstract>
Acute Drug Poisoning: Focus on Psychotropic Drugs
Department of Emergency and Critical Care Medicine, School of Medicine, Kitasato University
Psychiatria et Neurologia Japonica
117: 299-304, 2015
<Keywords:aspiration pneumonitis, activated charcoal, total bowel irrigation, multiple doses of activated charcoal>