Fatality Related to a 30-g Venlafaxine Overdose
Article first published online: 16 JAN 2012
2003 Pharmacotherapy Publications Inc.
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume 23, Issue 12, pages 1668–1672, December 2003
How to Cite
Mazur, J. E., Doty, J. D. and Krygiel, A. S. (2003), Fatality Related to a 30-g Venlafaxine Overdose. Pharmacotherapy, 23: 1668–1672. doi: 10.1592/phco.23.15.1668.31951
- Issue published online: 16 JAN 2012
- Article first published online: 16 JAN 2012
A 30-g venlafaxine overdose resulted in death for a 39-year-old woman whose 43-day clinical course was highlighted by refractory hypotension and the resulting complications of bowel ischemia and perforation. Her venlafaxine and O-desmethylvenlafaxine levels, analyzed by high-performance liquid chromatography one day after ingestion, were 21.82 mg/L (therapeutic range 0.1–0.5 mg/L) and 3.33 mg/L (0.2–0.4 mg/L), respectively. These levels remained elevated for over 7 days. Postulated explanations for these extended elevated levels were saturation of drug metabolism, decreased drug metabolism, and existence of a genetic polymorphism. Our patient's venlafaxine overdose produced a wide variety of clinical challenges, to include seizures, tachycardia, decreased level of consciousness, refractory hypotension, and bowel dysmotility. In addition, this case augments the growing body of literature that suggests that venlafaxine may be fatal in overdose situations.