Overdose : מינון יתר

4.9      Overdose

Experience with sertindole in acute overdose is limited. Fatal cases have occurred. However, patients taking estimated dosages up to 840 mg have recovered without sequelae. Reported signs and symptoms of overdose were somnolence, slurred speech, tachycardia, hypotension, and transient prolongation of the QT c interval. Cases of Torsade de Pointes have been observed, often in combination with other drugs known to induce TdP.
Treatment
In case of acute overdose, establishment of an airway and maintenance of adequate oxygenation should be ensured.

Continuous monitoring of ECG and vital signs should commence immediately. If the QTc interval is prolonged, it is recommended that the patient be monitored until the QTc interval has normalised. A half-life of sertindole of 2 to 4 days should be taken into account.

Intravenous access should be established, and the administration of activated charcoal with laxative should be considered. The possibility of multiple drug involvement should be considered.

There is no specific antidote to sertindole, and it is not dialysable, therefore appropriate supportive measures should be instituted. Hypotension and circulatory collapse should be treated with appropriate measures such as intravenous fluids. If sympathomimetic agents are used for vascular support, adrenaline and dopamine should be used with caution, since β stimulation combined with α 1 antagonism associated with sertindole may worsen hypotension.

If antiarrhythmic therapy is administered, agents such as quinidine, disopyramide and procainamide carry a theoretical hazard of QT interval-prolonging effects that might be additive to those of sertindole.

In cases of severe extrapyramidal symptoms, anticholinergic medication should be administered.
Close medical supervision and monitoring should continue until the patient recovers.