Selective serotonin reuptake inhibitors drug overdose

MDMA overdose as well as the concomitant consumption of selective serotonin reuptake inhibitors (SSRI) with other dmgs that exert serotoninergic effects (such as inhibitors of monoamine oxidase) can rapidly lead to the serotonin syndrome. Its symptoms, which are reversible upon cessation, of the drug include confusion, muscle rigidity in the lower limbs, and hyperthermia suggesting an acute reaction to serotonin overflow in the CNS. Blocking the function of SERT outside the brain causes side effects (e.g., nausea), which may be due to elevated 5HT however , impairment of transporter function is not equivalent to direct activation of 5HT recqrtors in causing adverse effects such as fibrosis and pulmonary hypertension. 

Pentel PR, Keyler DE, Haddad LM. Tricyclic antidepressants and selective serotonin reuptake inhibitors. In Haddad LM, Shannon MW, Winchester JF, eds. Clinical management of poisoning and drug overdose, 3 ed. Philadelphia WB Saunders Co, 1998 437-51. 

Atomoxetine, bupropion, and TCAs are second-line alternatives to the stimulants for treatment of ADHD in children, teens, and adults. The potential benefits of these agents in comparison with stimulants include reduced risk of abuse and somewhat lower potential for sleep disturbance. TCAs are the most dangerous in overdose and pose the greatest risk for cardiovascular side effects. The monoamine oxidase inhibitor tranylcypromine is effective but used infrequently due to the potential for dangerous drug and dietary interactions. Selective serotonin reuptake inhibitors (SSRIs) are not effective for ADHD. ... 

The selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment of depression in the elderly. Compared with tricyciic antidepressants (TCAs), they are much safer in overdose and, for the most part, their side-effects are better tolerated. The antidepressants that have been shown, in controlled studies, to be effective in geriatric major depression are the SSRIs fluoxetine, paroxetine, and sertraline, the TCAs clomipramine and nortriptyline, and the serotonin and norepinephrine reuptake inhibitor (SNRi) venlafaxine. Given that most antidepressants are effective in the elderly, the choice of drug is based on its side-effect profile and its potential to interact with other medications. 

Clomipramine, a tricyclic, is a more selective inhibitor of serotonin reuptake than other drugs in its class. This activity appears to be important in the treatment of obsessive-compulsive disorder (OCD). Patients with OCD are also responsive to sertraline and other selective serotonin reuptake inhibitors, and the SSRIs have now become the drugs of choice for this disorder since they are safer in overdose than tricyclics. The answer is (C). 

Serotonin-Selective Reuptake Inhibitors. Since their introduction in the mid-1980s SSRIs have become the most widely used of all antidepressants. This is largely because of their improved safety and tolerability in clinical use. Although the SSRIs are no more efficacious or rapid in onset of action than the tricyclics, they lack most of the serious toxicity and adverse side effects associated with the first-generation drugs. The relative absence of cardiac toxicity makes the SSRIs relatively safe in overdose (36). Fatal overdose... 

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