{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:45:45Z","timestamp":1768315545901,"version":"3.49.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Med. Toxicol."],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Vortioxetine is an antidepressant with a multimodal mechanism of action. It is used as a treatment option for patients with major depressive episodes. There have only been two previously reported non-fatal overdoses of vortioxetine; neither of these were analytically confirmed There has also been one case of serotonin syndrome potentially related to vortioxetine and two deaths where vortioxetine was detected. We report here a non-fatal analytically confirmed case of vortioxetine overdose.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case report<\/jats:title>\n                <jats:p>A 32-year-old male presented to the emergency department (ED) 12\u201313\u00a0h after oral ingestion of 1,260\u00a0mg of vortioxetine and 350\u00a0mg of diazepam. A family member reported that he had been drowsy after the overdose, but his level of consciousness and observations (heart rate, blood pressure and temperature) were normal on review by the pre-hospital emergency services and on arrival to the ED. During a period of observation, he did not develop any features of serotonin syndrome or any other significant toxicity. Toxicological analysis of a blood sample taken in the ED detected vortioxetine (plasma concentration 457 ng\/mL 10\u00a0h after ingestion) and sub-therapeutic concentrations of diazepam and pregabalin.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Despite having a plasma vortioxetine concentration nearly 15-times therapeutic vortioxetine concentrations, this patient did not develop any significant toxicity. In particular he did not develop any clinical or biochemical features of serotonin toxicity that would be expected with this class of antidepressant. Additional reporting of analytically confirmed vortioxetine overdoses will allow clinicians and licensing authorities to further understand the safety of this medication in overdose.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s13181-024-01027-8","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T18:04:41Z","timestamp":1722967481000},"page":"422-426","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analytically Confirmed Intentional Overdose of the Antidepressant Vortioxetine"],"prefix":"10.1007","volume":"20","author":[{"given":"Adam","family":"Daneshmend","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allon","family":"Gould","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Hudson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Robert Howard","family":"Archer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Ivor","family":"Dargan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-7237","authenticated-orcid":false,"given":"David Michael","family":"Wood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"1027_CR1","doi-asserted-by":"publisher","first-page":"2098","DOI":"10.1111\/bcp.14019]","volume":"85","author":"J Brett","year":"2019","unstructured":"Brett J, Wylie CE, Raubenheimer J, Isbister GK, Buckley NA. The relative lethal toxicity of pharmaceutical and illicit substances: a 16-year study of the Greater Newcastle Hunter Area, Australia. Br J Clin Pharmacol. 2019;85:2098\u2013107. https:\/\/doi.org\/10.1111\/bcp.14019].","journal-title":"Br J Clin Pharmacol"},{"key":"1027_CR2","unstructured":"Breen P, Butt A. Deaths related to drug poisoning in England and Wales: 2022 registrations. Office of National Statistics. 2023. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/deathsrelatedtodrugpoisoninginenglandandwales\/2022registrations [Last accessed 16 May 2024]."},{"key":"1027_CR3","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1192\/bjp.bp.109.070219]","volume":"196","author":"K Hawton","year":"2010","unstructured":"Hawton K, Bergen H, Simkin S, Cooper J, Waters K, Gunnell D, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. 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QJM. 2003;96:369\u201374. https:\/\/doi.org\/10.1093\/qjmed\/hcg062].","journal-title":"QJM"},{"key":"1027_CR6","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.2147\/TCRM.S55313","volume":"11","author":"W Bobo","year":"2015","unstructured":"Bobo W, Kelliny M, Croarkin P, Moore K. Profile of vortioxetine in the treatment of major depressive disorder: an overview of the primary and secondary literature. Ther Clin Risk Manag. 2015;11:1193\u2013212. https:\/\/doi.org\/10.2147\/TCRM.S55313].","journal-title":"Ther Clin Risk Manag"},{"key":"1027_CR7","unstructured":"European Medicines Agency. Brintellix (Vortioxetine) https:\/\/web.archive.org\/web\/20160126173553 [Last accessed 16 May 2024]."},{"key":"1027_CR8","unstructured":"US Food and Drug Administration (FDA) News Release. FDA approves new drug to treat major depressive disorder. https:\/\/web.archive.org\/web\/20131003083942\/https:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm370416.htm [Last accessed 16 May 2024]."},{"key":"1027_CR9","unstructured":"National Institute for Health and Clinical Excellence. Vortioxetine for treating major depressive episodes. Technol Apprais Guidel 367. 2015; https:\/\/www.nice.org.uk\/guidance\/ta367\/resources\/vortioxetine-for-treating-major-depressive-episodes-pdf-82602733813189 [Last accessed 16 May 2024]."},{"key":"1027_CR10","doi-asserted-by":"publisher","first-page":"17l02191","DOI":"10.4088\/PCC.17l02191]","volume":"20","author":"CY Ong","year":"2018","unstructured":"Ong CY, Vasanwala FF. Diaphoresis: a presentation of serotonin syndrome from vortioxetine. 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PID is an expert advisor to the UK Advisory Council on the Misuse of Drugs, European Monitoring Centre for Drugs and Drug Addiction, United Nations Office on Drugs and Crime and the World Health Organisation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}