• Medicina clinica · Apr 2024

    Retrospective analysis of venlafaxine-induced hypoglycemia in patients with overdose.

    • Isabel Gomila Muñiz, Lorenzo Socias Crespí, Jordi Puiguriguer Ferrando, Alexandra M Guiu Marti, Miguel Ángel Elorza Guerrero, and Bernardino Barceló Martín.
    • Servicio de Análisis Clínicos, Hospital Universitario Son Llàtzer, Palma de Mallorca, España; Grupo de Investigación en Toxicología Clínica, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España.
    • Med Clin (Barc). 2024 Apr 12; 162 (7): 328332328-332.

    IntroductionRecent publications relate the presence of hypoglycemia in venlafaxine (VLX) poisoning depending on the dose. Our aim was to analyze the clinical characteristics of patients who presented hypoglycemia induced by VLF overdose.Patients And MethodsRetrospective study carried out in the Balearic Islands (2020-2023).Inclusion Criteriaserum concentrations of VLX + O-desmethyl-venlafaxine (O-VLX)>800 ng/mL. The characteristics of patients with and without hypoglycemia were compared.ResultsTwenty-one patients were included, 8 (38.1%) with hypoglycemia. No differences were found in the doses referred to in both groups. Peak concentrations of VLX + O-VLX (ng/mL) were 9,783 [4,459-17,976] in patients with hypoglycemia and 1,413 [930-1,719] in patients without hypoglycemia (p<0.0001). The presence of hypoglycemia was associated with: lower age and level of consciousness; and higher frequency of suicide attempts, seizures, mydriasis, tachycardia and serotonin syndrome, invasive respiratory support, fluid therapy and ICU admission (p<0.05).ConclusionsThe detection of hypoglycemia in a VLX overdose case is a readily available marker to suspect the severity of the patient. In any case, serum concentrations when available allow us to confirm intoxication.Copyright © 2023. Published by Elsevier España, S.L.U.

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