SHM Converge Scientific Abstract ePoster Gallery-A Rare Case of Acute Respiratory Distress Syndrome in the Setting of Multiple Psychogenic Drugs Overdose

Pdf Summary

This case report describes a rare but serious complication of psychogenic drug overdose: acute respiratory distress syndrome (ARDS). A 41-year-old woman with bipolar disorder overdosed on risperidone and unknown amounts of lamotrigine, clonazepam, and venlafaxine. She arrived minimally responsive and later developed hypotension requiring large-volume IV fluids and norepinephrine. Initial labs and head CT were unrevealing, and ECG showed sinus tachycardia with mildly prolonged QTc.<br /><br />Although she was first admitted to telemetry, she later became agitated and then hypoxemic. Arterial blood gas confirmed severe oxygenation failure, and chest imaging showed bilateral diffuse infiltrates consistent with ARDS. She required intubation, ICU transfer, and management with ARDS protocol, including lung-protective ventilation and proning. Her course was further complicated by bradycardia and a PEA arrest, but she was successfully resuscitated, eventually extubated, and discharged to inpatient psychiatry.<br /><br />The discussion emphasizes that ARDS can occur after overdose of psychiatric medications, especially in polysubstance ingestions involving antidepressants, sedatives, antipsychotics, lithium, or stimulants. Proposed mechanisms include aspiration, direct lung injury, non-cardiogenic pulmonary edema, neurogenic pulmonary edema, and serotonin syndrome-related injury. Benzodiazepines and barbiturates may increase aspiration risk through CNS depression.<br /><br />The authors stress that clinicians should keep ARDS in the differential diagnosis when patients with psychogenic overdose develop worsening hypoxemia or respiratory failure. Early recognition, exclusion of cardiogenic causes, airway protection, mechanical ventilation, and ICU-level supportive care are essential and can be lifesaving.

Asset Subtitle

Sara Hassan

Meta Tag

Author List Anthony Diaz, Sara Hassan

Category Clinical Vignettes

Concept Psychiatric Drug Overdose

Concept Acute Respiratory Distress Syndrome

Concept Psychogenic Overdose

Concept Hypoxemia

Concept Airway Protection

Distinguished Non-Finalist

Presenter Organization Ocean University Medical Center

Presenting Author Sara Hassan

Track Adult

Keywords

acute respiratory distress syndrome

psychogenic drug overdose

polysubstance ingestion

risperidone

lamotrigine

clonazepam

venlafaxine

hypoxemia

intubation

ICU care

Psychiatric Drug Overdose

Acute Respiratory Distress Syndrome

Psychogenic Overdose

Hypoxemia

Airway Protection