Case history
Case history #1
A 38-year-old woman presents 3 hours after ingesting an overdose of sertraline tablets that she was prescribed for depression. She feels anxious and complains of blurred vision, tremor, and myoclonic jerking. On examination, she looks flushed and tremulous and appears mildly agitated. She is tachycardic (pulse rate 105 bpm), afebrile, and normotensive. On neurological examination she has hyper-reflexia (more so in the lower limbs), 6 beats of ankle clonus, and ocular clonus but normal tone.
Case history #2
An 18-year-old woman presents to hospital with severe agitation, confusion, and diaphoresis after taking an overdose of an unknown amount of her friend's phenelzine tablets. She is currently being treated for depression with escitalopram. On examination, she is non-responsive, tremulous, and rigid with spontaneous clonus. Her pulse rate is 165 bpm, blood pressure 160/120 mmHg, temperature 38.7°C (101.6°F), and oxygen saturation 91%.
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