Jovia Overdosage

Clinical data on escitalopram overdose are limited and many cases involve concomitant overdoses of other drugs. In the majority of cases, mild or no symptoms have been reported. Doses between 400 and 800 mg escitalopram alone have been taken without any severe symptoms. No fatalities or sequelae were reported in the few cases with a higher dose (one patient survived ingestion of either 2,400 or 4,800 mg).
Symptoms seen in reported overdose of escitalopram include symptoms mainly related to the CNS (ranging from dizziness, tremor, and agitation; to rare cases of serotonin syndrome, convulsion, and coma), the GI system (nausea/vomiting), the cardiovascular system (hypotension, tachycardia, arrhythmia and ECG changes (including QT prolongation), and electrolyte/fluid balance conditions (hypokalemia, hyponatremia).
There is no specific antidote. Establish and maintain an airway, ensure adequate oxygenation and respiratory function. The use of activated charcoal should be considered. Activated charcoal may reduce absorption of the drug if given within one or two hours after ingestion. In patients who are not fully conscious or have impaired gag reflex, consideration should be given to administering activated charcoal via a nasogastric tube, once the airway is protected. Cardiac and vital signs monitoring are recommended along with general symptomatic supportive measures. ECG monitoring is advised in case of overdose in patients with congestive heart failure/bradyarrhythmias, in patients using concomitant drugs that prolong the QT interval, or in patient with altered metabolism (e.g., impairment).
Due to the large volume of distribution of escitalopram, forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit. In managing overdosage, the possibility of multiple drug involvement must be considered.