Mild outcome after overdose of venlafaxine and zopiclone

The antidepressant venlafaxine in overdose can lead to serotonin syndrome, seizures and QTc interval prolongation and can increase the risk of cardiac arrhythmias. It has been reported to be more toxic in overdose than other new antidepressants. Several cases of lethal and non-lethal venlafaxine intoxications have been reported. We discuss a case of venlafaxine and zopiclone intoxication with a venlafaxine/O-desmethylvenlafaxine serum level of 2,861/2,670 ng/ml 22h after ingestion, which is one of the highest reported survived venlafaxine serum levels. Nonetheless no clinical signs of intoxication were observed. So venlafaxine overdose not necessarily leads to life-threatening signs of intoxication.