The pattern and the Outcome of Acute Antipsychotics' Intoxication: Possible Cardiotoxicity | ||||
| Egyptian Society of Clinical Toxicology Journal | ||||
| Volume 13, Issue 1, June 2025, Page 125-140 PDF (961.9 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/esctj.2025.379435.1087 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Manal Hassan Abd Elaziz1; Fatma Badr El Dine1; Rasha Mohamed Abayazeed2; Eman Mohamed Saleh1; Rasha Khedr   1
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| 1Forensic Medicine and Clinical Toxicology, Faculty of medicine, Alexandria University | ||||
| 2Cardiology and Angiology, Faculty of medicine, Alexandria University | ||||
| Abstract | ||||
| Background: Acute antipsychotic drug poisoning is a frequently encountered intoxication in clinical practice. Antipsychotic poisoning can lead to life-threatening cardiotoxicity, early diagnosis improve the patient's outcome. Aim of the work: The study aimed to evaluate the pattern of acute antipsychotics poisoning, the incidence of cardiotoxicity among acute antipsychotics poisoned patients and factors influencing this risk and the role of cardiac biomarkers in the diagnosis . Patients and method: The study enrolled 80 patients admitted to the Poison Center of Alexandria Main Hospital with a history of acute antipsychotics poisoning in a period from the January 2022 to the December 2022. Diagnosis depended on history, clinical symptoms and laboratory investigations. The data collected on admission, clinical examination and laboratory investigations were done including, serum levels of Brain Natriuretic Peptide (BNP), High sensitive cardiac troponin I (HscTroponin) Troponin I and Creatine kinase-MB (CKMB) Poison Severity Score (PSS) was calculated, and the outcome was recorded. Results: The cardiotoxicity was present in 86.25% of the cases. High significant association was present between cardiotoxicity and disturbed level of consciousness. Extrapyramidal effects and abnormal pupil findings were associated with the development of cardiotoxicity (11 times and 7 times risk respectively). Cardiac biomarkers showed insignificant elevation in the cardiotoxic group. The presence of cardiotoxicity is 13 times the risk for development of complications. About two-thirds of the patients developed complications. Conclusion: Cardiac toxicity should be suspected in almost all cases of acute antipsychotic poisoning. The presence of central nervous system affection, abnormal pupil findings, extrapyramidal effects are alarming risk for development of cardiotoxicity. | ||||
| Keywords | ||||
| Antipsychotic Poisoning; Cardiotoxicity; Risk Factor; Extrapyramidal Effects; PSS | ||||
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