# Single-Substance SSRI Intoxication: A Clinical and Outcome Profile Presentation in a Poisoning Referal Center

## TL;DR

This study examines the effects of single SSRI overdose, finding mostly mild symptoms and common heart-related issues like QT prolongation.

## Contribution

The study provides a clinical profile of single-substance SSRI poisoning, highlighting QT prolongation and serotonin syndrome occurrences.

## Key findings

- Most patients showed mild symptoms like nausea and vomiting.
- QT prolongation occurred in 31.6% of patients.
- Serotonin syndrome was diagnosed in 5.9% of cases.

## Abstract

Background: Due to the increasing concern about selective serotonin reuptake inhibitors (SSRIs) poisoning, specifically the risk of serotonin syndrome (SS), and the QT-prolonging effects of certain SSRIs, we evaluated the clinical presentations and outcomes of patients who overdosed on single SSRIs.

Methods: We carried out a cross-sectional study at a Poisoning Emergency referal center in Isfahan, Iran, involving 101 patients who had taken a single SSRI drug and were hospitalized between January 2021 and January 2024. Information on demographics, toxicological features, clinical symptoms, electrocardiogram (ECG) findings, and outcomes was gathered.

Results: The average age of the patients was 26.98 ± 10.57 years. Females outnumbered males (male to female ratio was 1:3.8). Sertraline was the most frequently ingested SSRI (43.6%), followed by fluoxetine (18.8%). Gastrointestinal symptoms (nausea and vomiting) were the most common clinical signs (n = 30, 29.7%). Six patients (5.9%) were diagnosed with SS. Only one patient experienced a brief, self-limiting seizure after consuming 4 g of sertraline. ECG showed QT interval prolongation (QT prolongation) in 32 patients (31.6%). One patient developed a first-degree AV block after taking 600 mg of citalopram. There was no significant difference in QT prolongation or SS based on the type of SSRI used. All patients survived without complications.

Conclusion: This study indicates that overdosing on a single SSRI typically results in mild to moderate clinical manifestations. Cardiac issues, such as QT prolongation, were relatively common among our patients.