In this section
Poisoning – Acute guidelines for initial management Serotonin Syndrome Serotonin and Noradrenaline Re-uptake Inhibitors (SNRIs) Poisoning Guideline
For 24 hour advice, contact Victorian Poisons Information Centre 13 11 26
Deliberate or accidental self-poisoning with selective serotonin re-uptake inhibitors [SSRIs] is common and usually follows a benign course. SSRIs are commonly used in the treatment of depression, anxiety and obsessive compulsive disorder in both children and adults.
Dose requiring medical assessment in paediatric accidental ingestions
Dose requiring assessment*
>5 mg/kg or >60 mg
>10 mg/kg or >100 mg
*Note these values do not apply to adolescents or adults please discuss with toxicologist
12 lead ECG, blood glucose and paracetamol concentration in deliberate self-poisoning.
Cardiac monitoring and serial ECG if large citalopram or escitalopram ingestion, duration of monitoring will depend on ingestion quantity (discuss with toxicologist).
Serotonin syndrome can be treated with titrated intravenous benzodiazepines (discuss with toxicologist)
Treat seizures with benzodiazepines
Cardiac monitoring if large citalopram or escitalopram ingestion
Observation for 12 hours is recommended based on the pharmacokinetics of the individual SSRIs
Contact Victorian Poisons Information Centre 13 11 26 for advice
Children and young people who develop severe serotonin syndrome should be managed in PICU
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Period of observation as above
For deliberate ingestion a risk assessment should indicate that the patient is at low risk of further self harm in the discharge setting
Accidental ingestion: Parent information sheet from Victorian Poisons Information centre
on the prevention of poisoning
self-harm: Referral to local mental health services e.g. Orygen Youth
Health: 1800 888 320
Recreational poisoning: Referral
Victoria's Youth Drug and Alcohol Advice service: 1800 458
Last updated November 2017