Trazodone toxicity

Background

• Extremely safe in overdose as long as there are no coingestants
• Has serotonergic and alpha blocking effects

Clinical Features

1. CNS depression
   1. Most common symptom
   2. Rarely produces coma or seizures when it is the only drug ingested
2. Respiratory depresion
   1. Fairly common (but only with coingestants)
3. Orthostatic hypotension
4. QT prolongation

Treatment

1. GI decontamination
   1. Activated charcoal x1
   2. Gastric lavage (consider for coingestants)
2. QT prolongation
   1. Treat torsades in usual manner
3. Hypotension
   1. IVF
   2. Norepinephrine
      1. Dopamine is contraindicated

Disposition

• Consider discharge for pts who remain asymptomatic for at least 6hr

Source

• Tintinalli