OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also anti-psychotic medications, toxicology

• Thioridazine & mesoridazine are the only anti-psychotics associated with single-drug fatal overdoses as these have quinidine-like actions & thus can induce ventricular arrhythmias, management of these should be as for tricyclic antidepressants. Other anti-psychotics are rarely fatal on OD.

• drowsiness, agitation, coma 
• NM excitability which may lead to convulsions (may be Mx with diazepam or phenytoin) 
• miotic pupils, decreased deep tendon reflexes 
• hypotension:
  • usually responds to fluid replacement
  • unresponsive hypotension may be managed with either noradrenaline / norepinephrine or dopamine ( in preference to adrenaline / epinephrine which will result in unwanted, unopposed beta-agonist activity causing vasodilatation!)
• hypothermia (though fever may occur later)
• delayed gastric emptying (hence gastric lavage may be useful even hrs after ingestion)