Journal of Research in Pharmacy Practice

Massive Citalopram Overdose Associated with Recurrent Seizures and Bilateral Shoulder Dislocations

Authors

. Shafeajafar Zoofaghari 1
. Anselm Wong 2
. Pegah Kiarasi 3
. Farzad Gheshlaghi 1

1 Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Emergency Department, Austin Toxicology Unit, Victorian Poisons Information Centre, Austin Health, Victoria, Australia Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia Department of Medicine and Radiology, Centre for Integrated Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia

3 Department of Clinical Toxicology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
Selective serotonin reuptake inhibitors (SSRIs) are widely used in the treatment of 
many types of mental disorders. Citalopram is commonly used as a new generation 
of SSRIs in this regard; however, unfortunately, its overdose is associated with 
seizure and heart disorders. The reported case in the present study indicated 
recurrent seizures, nonspecific ST-T changes, and prolonged QT interval due to 
the overuse of citalopram. The patient had bilateral anterior shoulder dislocation 
along with right proximal humerus fracture that was occurred during the seizure. 
The dislocation was initially reduced and then fixed. Moreover, the seizure was 
controlled with diazepam without any problems, and cardiac monitoring continued 
for 2 days. Massive citalopram overdose may be associated with recurrent seizures 
and QT prolongation. Complications postseizures, such as shoulder dislocations, 
should be examined for and managed appropriately.

Keywords

Citalopram
seizure
shoulder dislocation
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Journal of Research in Pharmacy Practice
Volume 9, Issue 3
Summer 2020
Pages 161-164

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