Key result
A massive venlafaxine overdose resulting in exceptionally high serum levels (2861 ng/mL VEN and 2670 ng/mL ODV) did not lead to life-threatening signs of intoxication in a 41-year-old female.
Case Report (n=1)
No
Massive venlafaxine overdose resulting in extremely high serum levels does not necessarily lead to life-threatening clinical signs of intoxication such as QTc prolongation or seizures.
High venlafaxine levels may not predict severe toxicity; this case leaves open questions on individualized risk thresholds.
The antidepressant venlafaxine in overdose can lead to serotonin syndrome, seizures, QTc interval prolongation and can increase the risk of cardiac arrhythmias. It has been reported to be more toxic in overdose than other new antidepressants. We report a case of venlafaxine intoxication with a venlafaxine/O-desmethylvenlafaxine serum level of 2861/2670 ng/mL 22 h after ingestion. This is one of the so far highest survived venlafaxin serum levels. In contrast to other reported survived venlafaxin overdoses with high serum levels no clinical signs of intoxication were observed in our case. So venlafaxine overdose not necessarily leads to life-threatening signs of intoxication.
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Fischer et al. (2012) conducted a case report in Venlafaxine overdose (n=1). Venlafaxine overdose was evaluated on Clinical signs of intoxication and serum levels. A massive venlafaxine overdose resulting in exceptionally high serum levels (2861 ng/mL VEN and 2670 ng/mL ODV) did not lead to life-threatening signs of intoxication in a 41-year-old female.
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